Brian Center Nursing Care – St. Andrews in Columbia, SC, has been cited for failing to prevent falls for its residents. This facility was profiled in one of our previous blog posts after failing to follow state reporting regulations, which you can read about Brian Center Nursing Care’s other citation.
In the span of a year, one specific resident fell three times. Nursing home falls are treated very seriously, as they can have lasting implications for a resident’s health, mobility, and overall quality of life. Three falls over a series of months is significant, showing the nursing home’s failure to prioritize the protection of this resident by preventing their injury.
In the third fall, the resident gained a lump on their forehead, three scratches on their leg, and a small scratch on the bridge of their nose. This resident was known to have a “decreased awareness of their own safety,” leaning forward in their wheelchair in a way that put them at serious risk of falling, even when they were in a wheelchair.
The nursing home had a plan to prevent falls for the resident, including keeping important items within easy reach in their room to discourage the resident from leaning forward too far. The resident’s area was kept clear of clutter and had fall mats to reduce the severity of a possible fall. These interventions were well-intentioned, but this resident was known to lean too far forward in their wheelchair. This concern put the resident at risk during the times they moved around the facility and outside of their room.
The facility was also cited for the injury of a second resident, who also had a history of falls. The resident was first found sitting on the floor mat in their room with a bruise and swelling to the left inner arm. The resident received an x-ray, which revealed an acute humeral neck fracture. When a state surveyor reviewed this resident’s file, they found four additional falls that occurred within the weeks leading up to this serious injury. This resident had been injured multiple times and eventually suffered a neck fracture because the facility did not prevent the resident’s falls.
The second resident had a history of Dementia and had been marked as a high risk for falls. The resident’s care plan outlined a strategy of keeping the resident’s area clear of debris and clutter and keeping frequently-used items close by. The resident was to be transported by wheelchair, but there were no additional interventions listed. This resident was a clear risk for falls and had fallen multiple times in a very short period.
Fall risk is common in nursing homes, as there are many conditions which can make falls more likely. The responsibility of a nursing home, in this case, was to make and follow a plan for each resident that would address their daily needs in addition to preventing their injury. Nursing home residents depend completely on the facility to ensure their safety. Closer supervision or a more robust care plan could have made all the difference for these residents.
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