By: Linda Winston
An 83-year-old resident, identified as an elopement risk and with a WanderGuard bracelet in place, was able to get on the elevator at 10:30 in the evening and leave the locked unit unsupervised. A nurse in another unit returned her to the locked unit. The nurse on the locked unit did not report the resident’s elopement to anyone. Staff involved mistakenly felt that since the resident did not leave the building, it was not a significant event. However, if a resident is able to access any area inside or outside of the building they should not be in, it is considered elopement and a very serious situation.
Residents may move throughout the day within a skilled nursing facility. It is important for staff to know where assigned residents are throughout the shift. Staff should also be aware of those residents who may wander or exit seek or have a history of elopement. It is important that staff have knowledge of the appropriate steps to take should a resident go missing.
According to the Centers for Medicare and Medicaid Services (CMS), state operations (SOM) Appendix PP March 8, 2017, “elopement occurs when a resident leaves the premises or a safe area without authorization (i.e., an order for discharge or leave of absence) and/or any necessary supervision to do so.” (p. 296).
Often, the staff understand elopement occurs when a resident leaves the building. The above CMS definition includes residents who leave a locked unit or are found in an unsafe area of the skilled nursing facility without authorization and/or unsupervised.
Centers for Medicare and Medicaid Service (March 8, 2017). State Operations Manual Appendix PP. Retrieved from https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R168SOMA.pdf
