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My mother has had a really rough last 3 months.She has had 2 strokes leaving her with extreme right side weakness.The last stroke was 6 weeks ago during the time my father was on hospice following a dx of stage 4 lung cancer.She was placed in rehab after discharge where she experienced several falls.She was transferred back to the hospital after being found unresponsive in her w/c in her room,CTs did not show any further stroke,however after this episode she has been pretty confused.She was moved back to the rehab after being discharged,spent a few days at the rehab and took another fall and was sent back to the hospital where she was treated for double pneumonia and had a PICC line placed for IV antibiotics and sent back to the rehab where she was placed in a room halfway down the hall from the nurses station.I had called the rehab and talked with the nurse and told her about the confusion nd her trying to get up while in the hospital and my brother spoke with them face to face.She had not been there 2 hours until we were receiving a call telling us that she was found on the floor in her room after slipping out of her wc. The nurse stated that they had pushed her in there after lunch(WHAT!! by herself).They then did nothing to prevent another fall in my eyes.She remained in the same room,they have no alarm system to alert staff to a pt. attempting to get up(magnetic alarm would be good). We have ordered one ourselves in an attempt to keep her safe,the staff have been told countless times to call us if they need us for anything including sitting with her.They have not once called us to come sit with her and they generally do not allow family to stay so we would not know unless they called.I said all this to say this that vey same day at 11:26 pm the nurse called me to let me know that my mom had been found in the bathroom on the floor of the shower.She had scrapes and bruises and could not lift her right arm.A xray the next morning showed she had fractured her right shoulder.So what are ya'lls opinion about possible liability on their part?

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I agree with ihopeithelps.
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They are defiantly liable for her repeated falls, especially if they did not take appropriate measures to prevent the fall. After every fall they should have had a meeting and decide a course of action to prevent further falls. Leaving her un attended, with out safety precautions is defiantly neglectful. Contact the ombudsman and public health to get them to take the issue seriously. I would also suggest looking for another facility. Preventing falls is often the main focus of most facilities, so if they are neglectful in this area, I would really be concerned about other issues such as hydration and skin break down. I wish your family the best you guys are going through a lot. God bless you all.
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Supervision is key whether it be child care or elder care. Today in our facility 5 staff were in the break room immediately following lunch (some residents were still finishing up). The others were helping patients elsewhere. Not one staff person in the community room overseeing the 10 people there. And they wonder why I filed a complaint?!@#$%^&
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Yep to vstefans!
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In response to "Husband", may I please have the name of the facility in MD where your wife is receiving good care? I have already reported one facility (when my cousin contracted MRSA), and certainly could use a recommendation. Thank you.
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With all the efforts we typicaly make even at a PEDIATRIC hospital to prevent falls, where relatively few patients have fragile bones, I can't believe this facility does so little and thinks it is OK. I am not a lawyer and can't tell you too much about the legal case you might have, but the Office of Long Term Care needs to know about this for sure, unless your use of the grievance procedure (which MUST be posted) is more satisfactory than I expect it is going to be. There are rules about unecessary restraints but as Husband noted above there are ways around this if you give two hoots about patient well-being.
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Regulations in CA and probably just about everywhere state that one of the jobs of a facility is to provide supervision for its residents. Certainly, the staff cannot be in each patients room but the common areas and corriders should be well staffed. If not, it is a violation of the regulations.

If you need to restrain a resident/patient please know they are not being tied up! Geeeze...that is alarmist language and its not true. There are seat belts that affix to a wheel chair ...there is a click clasp and velcro and most patients know how to undo these. The key of course is when/if they undo the belt an alarm sounds and staff should be at the ready (adequate supervision) to make sure the resident does not stand/fall.

Restraints in bed are referred to as soft restraints and can be used for medical reasons with doctors orders. the patent cannot leave the bed (many are in diapers anyway) but it provides enough freedom of movement to turn over on their sides during sleep.
By the time most magnetic alarms sound the patient is already on his/her feet so its hard to prevent a fall using this device.
You can search the internet for safe methods...lowered beds, padded floors etc.
Because of the adequate supervison piece the facility should be liable!
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My opinion is that they SHOULD be liable, since they were advised of her situation and did nothing to keep her secure!
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Our mom is 86, at home and presents a serious fall risk. She refuses to use the walker, won't remove throw rugs. Even in a nursing home, if the patient won't ring the button and wait for help, they will fall. You could have the MD order restraints, but that means tying her to a chair or bed.
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I've worked in rehab facilities, so I tend to sympathize with them. They are not allowed to restrain the patient and can't be there with them constantly. You are horrified that she was in her room by herself, but you are not paying for a private nurse, so I'm not sure what you expect them to do. I'm having the same issue at home with my Dad. He doesn't use the walker or the wheelchair on his own. I have to insist that he use them when I'm there, but I sleep and take showers. I'm not in the same room with him 24/7. I have a magnetic alarm on the front door, but he's too wild a sleeper to make an alarm on his clothing a workable solution. He falls sometimes, but never has more than a scraped knee or elbow. Maybe I have too casual an attitude, but I have to balance my abilities with his inabilities and realize that he will not live forever no matter what I do. If you need proof of that statement, try to imagine caring for your mother in your home for a week.
On the other hand, I agree with those who think you can do better as far as this rehab facility. You need 24 hour access to your Mother and that should be encouraged by any facility.
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In CA the regulations state that family has "immediate access" even tho the facility trys to enforce visiting hours. Its a good idea for find out the NH/AL laws and regulations. (your state was not mentioned). In CA therefore, if they try to enforce visiting hours we have a regulation code and if they persist they are violating the regulations. Did you know the basic premise is this: NH residents have the same rights as any American Citizen and they do not lose their rights when they begin living in a facility!!!

Many patients can get caught in the bed rails that will often result in a fall.
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I recently filed a complaint with The Dept. of Public Health in my state due to similar circumstances. The facility was faulted and were "reprimanded". Whatever that means.... I took her home and I kept her home. She passed on 8/18. I am so glad that I took her out of there when I did and let her go with dignity and in the safety of my home. I realize this is not an option for everyone and was a drain financially and emotionally. She is at peace now.
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A different view that you may wish to consider is how my experience is going.
My FIL is very determined. They have alarms on him, his seat, his bathroom door, motion detectors on the floor and so on. He continues to try to do things himself, because he forgets that he cannot do them on his own. The alarms are a warning, a preventative, but they don't stop anything from happening. The staff where my FIL is so apologetic, but, we understand that UNLESS THEY CAN STRAP HIM IN -- he is going to continue to try and continue to fall. And it is against the law to restrain him in a wheelchair. The staff is wonderful and we understand that it is not their negligence, it is just the way it is. Determined and forgetful make a bad combination. Good Luck!
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I agree with ferris1 - get her out of there ASAP.
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How I can empathize with your situation, nanaof2! There's a lot of good advice here; ferris1 suggested that you file a complaint w/your state's licensing board & that is GREAT advice. In Illinois there is a state Ombudsperson who handles elder care nursing home complaints; I believe most states are required to have one. I found mine by Googling "Elder Care Ombudsperson for State of IL" and it came right up. Try it! Our Ombudsperson is wonderful. He is helping my family untangle all the glitches involved w/Medicaid and has been there every step of the way for us. I can't urge you enough to look into this!!
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I cared for my Grandmother when she was ill. She had to be in the hospital for a very short time and I stayed with her except one night. You guessed it she fell that night. When the hospital called I asked if she was looking for me, the response was "she is always looking for you". I never left her again. She told the Dr I want to go home, my lassie(that was me) will take care of me. I did, and I will always be thankful I was able to. If you have to place your Mom again find a place with a better track record.
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Forget about lawyers! My advice would be to remove your mother from this facility as soon as possible. As a nurse, she obviously is not being watched and cared for with her limitations in mind. I find it odd the staff doesn't want you to stay and watch her. There is nothing that should preclude you from staying unless they don't want you to see them not doing their jobs. I have worked at several facilities where staff didn't really care about their patients and as with everything else you need to investigate what goes on in this facility. But, your immediate concern should be for your mother's welfare. Any fractured limb has to be documented in nurse's notes, but it will come down to either not knowing what actually happened to no one wanting to accept blame. She should have at least been wearing a safety belt due to her being able to slide out of her wheelchair. Then she would not have been able to get out, slip and fall. I would file a complaint with the nursing board and state licensing board about this facility. I hope you can find another placement or you take her home with you. Best wishes.
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I don't like assisted living or nursing homes because they charge big money make lots of promises, but...lack of supplies, pads, no alarms does not surprise me.
I was a CNA and worked in the homes; i know how it is. Understaffed, always crying about money, not adequate supplies or i, BUT someone is making huge bucks out of it; it sure is not the working staff. So..I have been taking care of my mom in my own home for three years because i don't want her in one of those places.
Yes, I can only work part-time and hire help; which i pay for with her social security. She is very hard to deal with at times (dementia) but seems much happier here. I know she will eventually have to be in a secure facility because after awhile they don't listen to you at all and can hurt themselves, etc.
About falls- they can fall anywhere; you can't protect them all the time, really.
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As sad as it is lets face it "Rehab is big business" Lots of money to be made in that field. Keeping the overhead down, top nursing care, in house Doctors, cheap or inferior drugs seems to be the name of the game. On an average I spend 10 to 12 hours with my wife each day to support her and over see her care. I have learned to trust no one.
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When I read that the facility limits visiting time that to me was a red flag as well. Most facilities have an open door policy where family can come and go at will, 24/7.
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I would speak to her doctor and transfer her to a better rehab. This facility isn't providing proper supervision of your mother and the care is lacking. You have went from a stroke victim needing assistance to recover to a person with a broken shoulder ---OMG. I would insist on interviewing the rehab facilities before the transfer to make sure they actually provide care. Meanwhile get a paid home health aide into the facility to prevent more falls or be at the facility most of each day. When she needs to be moved observe the transfers, demand at least 2 people assist her as she moves from bed to wheelchair or is taken to the bathroom/or beside commode. Meet with the PT and see what they can do for her and make sure she gets some PT to overcome the weakness. Of course, the shoulder will not be doing much until it heals.

ASAP almost live in the facility and have a paid home health aide there overnight to ensure no more unnecessary injuries. Get the doctor to arrange a transfer to an effective rehab. I would have figured out the facility trying to limit access to an elder is a real RED Flag.
Once your mother is out of this place, you could see if you have a case for neglect with a competent attorney. However, document at home all the contacts dates, times of these falls. The fact that she is walking around with nobody helping her seems to point to neglect case--it is happening over and over again.

I fear for you mother's safety---time to step up she needs a protector.
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Dear husband give hug,

That was exactly my point...rehabs are definitely not all the same...some care...some don't...and the only way to know the difference is through bitter or pleasant experience...depending on the place.
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I had the same problem in MD. My wife had a major stroke affecting left side of her body. In short she went from hospital to rehab. During her stay in rehab I got 3 phone calls in the middle of the night telling me she had fallen out of bed. Questioning my wife she told me "I had to go to the bathroom" and that was way she fell. I asked way they didn't keep her bed rails up to keep her from falling. I was told they had to keep one side down that it was the law. Keeping all the rails up is caging a person. After she got out of the rehab I made a decision never to send her again to a rehab again. As time went on my wife had many more hospital / rehab events happen. I told the social worker at the hospital I would not agree if were sending her to the same rehab unit she was first in. Another rehab unit was selected and her care was %100 improvement. Soft rubber mats were put around her bed just in case she fell. There were items added that keep her from rolling out of bed. Depending on my wife's status they would keep her out of the wheelchair and put her in a lounge chair with wheels. It changed her center of gravity and little chance of falling. Right now my wife is back in rehab again after a 4 week stay in the hospital. I agreed to the rehab she is now because of the better care she had gotten in the past. So far I have not been disappointed in her care. In closing I will say not all rehabs are the same. Some are good and some are bad.
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The facility I had my mom in...Parker Rehab at the LIJ in NY told me to remove my mother from their care if I didn't like their system of attaching electronic motion sensors to her, which she would remove (she had a mild form of dementia). She fell three times and injured her head but they would not watch her. Neither would Ozanam Rehab. So I had to remove her and put her somewhere else where they kept watch on her. Lawsuit? Forget about it.
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I had a similar problem with a rehab facility in Texas. My mother got pneumonia and suffered a mild heart attack by being misdiagnosed by the staff doctor. When she first got sick, I talked to the staff and told them that being an asthmatic she had to be watched closely. As the paramedics arrived to transport her to the hospital, the nurse on duty insisted that my mother's lungs were clear. All the other nurses came running, and I told them to go away. I consulted with a few attorneys, and they said the only way you can file suit here is if the patient actually dies.
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