Resident Develops Pressures Wounds at KeyStone Place
Resident neglect at the Minnesota Keystone Place at LaValle Fields was cited by the MDH. The Minnesota Department of Health investigated an allegation of maltreatment, in accordance with the Minnesota Reporting of Maltreatment of Vulnerable Adults Act, Minn. Stat. 626.557, and to evaluate compliance with applicable licensing standards for the provider type.
According to the report, the resident was neglected when facility staff failed to provide the necessary care and services to a cognitively impaired resident. As a result, the facility failed to identify the resident had developed a large serious sacral wound requiring hospitalization and debridement.n
Failing to Reposition Leads to Sacral Wounds
The Minnesota Department of Health determined neglect was substantiated.
The Minnesota Department of Health determined neglect was substantiated. The facility was responsible for the maltreatment. The facility failed to ensure the resident’s plan of care directed staff on the residents individualized care needs. Unlicensed staff documented at times the resident would refuse staff assistance, however, nursing failed to follow up on the resident refusals to ensure the resident was receiving assistance with personal cares. The licensed nurse saw the residents sacral wound and transferred the resident to the emergency department. The resident was hospitalized, and required wound debridement, and wound care as a result of the neglect.
When interviewed a hospital case manager (a registered nurse) stated the resident’s wound were caused by prolonged exposure to urinary incontinence and poor hygiene. The case manager stated hospital providers and wound care nurses indicated based on the severity and extent of the wound it had likely been present for months and was painful to the resident. The case manager stated the extent of the wound was disturbing, and she had never seen anything like it before. The case manager indicated the resident was not able to make decisions about her care and services due to cognitive impairment, and the resident’s medical power of attorney was not aware the resident was refusing services at the facility. When interviewed several unlicensed staff indicated the resident refused toileting reminders and assistance and would not allow staff to be in the room to assist with bathing or toileting. As a result, none of the staff had observed the resident’s skin prior to the incident. The staff indicated they documented refusals on the TAR for nursing to follow up on. Staff stated facility nursing staff were aware the resident refused assistance prior to the incident because they often discussed the resident’s refusals during change of shift with the facility nurses. In conclusion, the Minnesota Department of Health determined neglect was substantiated.
Contact An Experienced Attorney to Review Your Case
If you have questions or concerns about nursing home injuries and accident, from pressure ulcers or wounds including those which lead to a wrongful death suffered by someone you love contact Attorney Kenneth LaBore for a Free Consultation at 612-743-9048.