Could the failure of a skilled nursing facility to anticipate and protect residents from potential injury due to repeated and unimpeded intrusions by deer lead to potential false claims submissions for substandard quality of care? [F921 Safe/Functional/Sanitary/Comfortable Environment]
Compliance Perspective – Preventing Injury
Policies and Procedures: The Compliance and Ethics Officer should ensure that the facility has policies and procedures to address unexpected intrusion by wildlife, e.g., a deer crashing into a resident’s room.
Training: Staff must be trained about how to respond to all types of situations involving unexpected intrusions by wildlife—deer, racoons, snakes, etc. Training should involve drills involving a variety of situations. The facility will address the policy and procedure regarding potential wildlife intrusion at a Resident Safety Meeting.
Audit: An audit should be conducted to determine if there are areas in the facility where an unexpected intrusion might occur. The results of the audit will be summarized and submitted to QAPI/QAA Committee and the Compliance Committee.
The quick response of nursing home staff prevented injury to a resident in the assisted living center when a large 8-point buck crashed through a window. Staff got between the thrashing deer and the resident and were able remove her unharmed. They left the room and closed the door, leaving the disoriented, wounded animal behind to wreak havoc on the furniture and equipment.
The center’s administrator was in his office and saw the deer approaching the center. He described it saying, “I just glanced and saw the 8-poing buck deer walking toward our facility. He was huge, and he was just walking—not running. He got into our grass area, then disappeared.” He said he thought to himself, “That was strange.”
The administrator said he almost immediately heard the commotion from the south end of the center and in the few seconds it took for him to get to the scene, 
the staff had managed to get the resident out of the room and call 911.
The heroic staff included the discharge planner, the medical director and a certified nursing assistant who were near the nurse’s station close to the resident’s room.
Since it is mating season for deer, it is thought that the large buck saw his own reflection in the window and charged at it, thinking he saw another buck. Because the animal was injured, police had to euthanize the deer.
The center employed a local company that professionally removes blood from automobiles and homes to clean up the mess left by the thrashing deer. A crew arrived that evening and were able to clean the room in a little more than an hour.
