Patient falls and state visits

[ptvgirl]

Does the state (dept of health) make a visit after every resident that has a fall in a snf? I have seen them come in a lot of the times. But can't remember if it is everytime.

[ptvgirl]

Does the state visit after each fall that is reported? I have seen the state come visit after some falls had and other times not. Do they always come or does it depend on something?

[DHawkinsrn]

It depends on the circumstances surrounding the fall. If there was a fall with injury the state may come due to an FRI being sent. If a family has complaints about a fall and calls the state, they could come.

[amoLucia]

All fractures are usually required to be reported to the State, be they fracture r/t to a fall or of unknown origin. That's the responsibility of your administration. So if a place has an significant number of fractures, esp when reported occurring with a fall, the State may well come for an investigative visit.

Also, hospital ERs have been known to call the State directly themselves when they see unusual bruises post-fall that might suggest abuse. Hospitals are mandated reporters for suspected abuse.

Also, the first poster is right about family complaints possibly initiating an investigation.

To DH - what's an FRI? I'm guessing it's a report to the State?

[ptvgirl]

If a resident states they fell, but did not mention it to anyone until the next day after it happened and now one ever saw this resident fall, but they said they did would that consider a visit from the state?

[Blackcat99]

Good question. That happens sometimes at my LTC. I get a phone call from the DON sometimes asking if so and so fell on my shift.

The patient tells her family that she fell and nobody did anything about it. However, the patient doesn't tell the nurses or the CNA's that they fell. The patient only tells her family member that she fell.

[LoveMyBugs, BSN, CNA, RN]

The state can come in anytime someone makes a complaint. They dont have to, but say someone be it be a patient, family member or staff calls a complaint in, the state can come in to investigate.

I worked in a SNF and state was in all the time doing investigations, we had a lot of BH patients who would make accusations and those accusations would need to be investigated

[bluegeegoo2, LPN]

Good question. That happens sometimes at my LTC. I get a phone call from the DON sometimes asking if so and so fell on my shift.

The patient tells her family that she fell and nobody did anything about it. However, the patient doesn't tell the nurses or the CNA's that they fell. The patient only tells her family member that she fell.

Don'tcha just LOVE that? I've had the police show up because a res called a family member and said one of our staff "slapped" her, and the family called police. Of course, she never mentioned any such thing to us. Fortunately, she was care planned for false reporting, as she had a lengthy history of false accusations against staff. The investigation found no wrongdoing but state did come in for it.

[CT Pixie, BSN, RN]

I work LTC and I've never seen the State come in for a fall.

I'll take a stab at 'FRI'....frature related incident?

[LadyFree28, BSN, LPN, RN]

If a resident states they fell, but did not mention it to anyone until the next day after it happened and now one ever saw this resident fall, but they said they did would that consider a visit from the state?

No; once the resident states that they fell and reported it, we do a fall investigation, incident report, contact the family and the DON, place the resident on frequent assessments, and change in condition.

As some of the posters stated the state will come in on a complaint, not necessarily falls; it might be a fall; might be something else; they will visit units and talk to residents to find out if they think they are being properly cared for, though depending on the resident that they interview, it could be hit or miss.

[DHawkinsrn]

All fractures are usually required to be reported to the State, be they fracture r/t to a fall or of unknown origin. That's the responsibility of your administration. So if a place has an significant number of fractures, esp when reported occurring with a fall, the State may well come for an investigative visit.

Also, hospital ERs have been known to call the State directly themselves when they see unusual bruises post-fall that might suggest abuse. Hospitals are mandated reporters for suspected abuse.

Also, the first poster is right about family complaints possibly initiating an investigation.

To DH - what's an FRI? I'm guessing it's a report to the State?

It's a Facility Reportable Incident, yes its a report to the state.

[CapeCodMermaid, RN]

The DPH doesn't come out as frequently as they used to. In Massachusetts, they don't always come out for a fall with fracture. If the resident is an independent ambulator, they usually won't come out. When they do come out, they review the chart, the investigation, and especially the care plan that was in place at the time of the fall.