Could the repeated failure to complete initial baseline care plans and fall risk assessments lead to submission of false claims? [F655 Comprehensive Person-Centered Care Planning/Baseline Care Plan and F689 Free of Accident Hazards/Supervision/Devices]
Compliance Perspective – Neglect of Resident
Policies/Procedures: The Compliance and Ethics Officer and DON will review the policies and procedures for conducting initial resident-centered baseline care plans, including fall risk assessments upon admission.
Training: Staff must be trained on developing and maintaining resident-centered baseline care plans including fall risk assessments with interventions and preventive measures within 48 hours of admission.
Audit: An audit will be conducted to evaluate the baseline and comprehensive care plans and the fall risk assessments for new admissions and all other residents at risk of falling. The completed audits will be summarized and submitted to the QAPI/QAA Committee and the Compliance and Ethics Committee for review and recommendation.
A relative acting under a power of attorney for a resident in an Illinois nursing home has filed a complaint on her behalf alleging a nurse and the nursing home operators failed to properly care for a resident in violation of the Illinois Nursing Home Care Act.
The plaintiff contends that when the resident was first admitted to the facility after a fall, the nursing home was negligent because it “failed to ensure the patient’s health and safety, failed to provide wound care treatment or adequate hydration” and did not provide a fall risk care plan with interventions to prevent further falls.
Also, according to the complaint, the resident “suffered multiple falls that resulted in a sub-capital femoral fracture, skin breakdown, a pressure ulcer and a sacral ulcer” due to the nursing home’s neglect.
The plaintiff is requesting a jury trial and is seeking a judgement against the nursing home “in excess of the jurisdictional limits of the court.”
