Could the failure of a nursing home to provide adequate supervision and care planning for a resident known to be at risk of elopement and harm result in submitting a false claim?
Compliance Perspective – Elopement
Policies/Procedures: The Compliance and Ethics Officer with the Maintenance Director will review policies and procedures involving resident room window security and resident safety.
Training: The Compliance and Ethics Officer will ensure that staff are trained to respond in a timely manner to concerns about window security and resident safety.
Audit: The Compliance and Ethics Officer with the Maintenance Director should conduct an audit of window security compliance and ensure policies and procedures are being followed regarding window security and resident safety, and that staff are responding timely to safety issues.
A New York nursing home failed to implement steps to ensure a resident’s safety, although the maintenance director warned the administrator and nursing staff that the resident might be trying to elope because of his repeated removal of the screws placed in his room’s window to prevent it from being opened more than six inches.
The resident was identified as having a risk for elopement when he was admitted. He was also resistant to receiving care and medications and was noted as saying often, “I’m getting out of here.”
Early on June 4, the resident used a make-shift rope created by tying his clothes together to exit from a third-story window and fell 34 feet. He died while being transported to the hospital.
State inspectors found that the resident’s care plan did not include a plan to prevent elopement or to monitor his location, but it did note that the resident believed he was in jail.
Along with a $10,000 fine, the state recommended that the Centers for Medicare & Medicaid Services (CMS) fine the facility. The state cited the facility for other violations including the failure to provide an environment that was free of accident hazards, failing to employ a qualified social worker and failure to provide residents with medically-related social services.
