An 82-year-old Ohio nursing home resident with dementia was found dead from hypothermia in a wooded area behind her facility. Her son said he believes the staff at the nursing home had lost track of her and mistakenly thought she had been signed out of the facility by family.
The son and his wife said they first knew something was wrong when they received a phone call from the facility asking when they were bringing their mother back. They replied that they didn’t have her, and they asked what the facility was talking about.
The couple then rushed to the nursing home and said they were met with confusion among the staff. No one seemed to know where their mother was. Then an employee at the front desk told them that their mother had been found but didn’t explain where she was. A firefighter eventually told them that their mother was found dead in a wooded area behind the building and that she’d been there for a while.
The son said he thinks his mother may have been out in the elements for at least forty hours. The couple said they were told by an employee that the resident had not been in her room to receive medication at 5 p.m. two days earlier. According to the couple, the employee also indicated that the resident was marked in the system as signed out of the building by the family, but relatives had not done that.
The Ohio Department of Health will now conduct an investigation. The resident’s family have hired attorneys as they are considering filing a civil lawsuit.
Compliance Perspective
Issue
Facilities should have policies in place that clearly define the mechanisms and procedures for assessing or identifying, monitoring, and managing residents at risk for elopement to help minimize the risk of a resident leaving a safe area without the facility’s awareness and/or appropriate supervision. In addition, the resident at risk should have interventions in their comprehensive plan of care to address the potential for elopement. Furthermore, a facility’s disaster and emergency preparedness plan should include a plan to locate a missing resident. While wander, door, or building alarms can help to monitor a resident’s activities, staff must be vigilant in order to respond to them in a timely manner. Alarms do not replace necessary supervision, and require scheduled maintenance and testing to ensure proper functioning.
Discussion Points
- Review policies and procedures regarding prevention of and response to resident elopement to determine if any changes should be implemented. Also review policies and procedures for ensuring provision of adequate monitoring, sufficient staffing, and that there is adequate security to prevent residents from wandering away from the facility.
- Train staff regarding the importance of providing adequate monitoring and care for the residents. Conduct elopement drills to ensure staff on all shifts know how to competently respond.
- Periodically audit to ensure that residents’ elopement risk assessments are completed at the time of admission and updated periodically and as needed. Also audit to ensure that staff are performing assigned checks of residents.
*This news alert has been prepared by Med-Net Concepts, LLC for informational purposes only and is not intended to provide legal advice.*
