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]

Do facilities have to report all falls or skin issues that occurred in their facility to the state? I remember overhearing my DON saying something along those lines. But didn't understand why

[CapeCodMermaid, RN]

No. You must report any fall with a fracture or other serious injury. I report the fall if the resident is sent to the hospital even if there is no fracture found. They can't cite you for over- reporting. If a resident falls and receives no injury, it does not to be reported to the state.

However, if you have a frequent faller, even if they have no injuries, you'd better have a good care plan in place.

[TheCommuter, BSN, RN]

This is dependent on the state in which you are practicing.

In the state where I work, surveyors come to the building to investigate falls only if one or more of the following conditions have been met:

1. A severe injury such as a fracture occurred as a result of the fall

2. A resident died due to injuries sustained after falling

3. The fallen resident or a family member has complained to the state

4. Management at the nursing home has self-reported the fall

[ptvgirl]

Do all self reports to state results in a state visit? Or doesn't depend on whether the state feels they need to visit because of the incident that was reported?

[ptvgirl]

No. You must report any fall with a fracture or other serious injury. I report the fall if the resident is sent to the hospital even if there is no fracture found. They can't cite you for over- reporting. If a resident falls and receives no injury, it does not to be reported to the state.

However, if you have a frequent faller, even if they have no injuries, you'd better have a good care plan in place.

So they would come if the resident has become a frequent faller ?

[CapeCodMermaid, RN]

I think we've answered the question. They don't come out on every report I send in. They don't come out on every fracture...they come when they come. If a resident falls 17 times without an injury, the state has no way of knowing unless they pick that resident's chart during survey.

[amoLucia]

To any newbie nurses out there - if any pt (or other pt or visitor) so much as even whiffs about having fallen, take it seriously and proceed as if it were a real occurrence. Your documentation should comment that this was an UNWITNESSED event. You would do all your routine steps as in a 'for real' investigation. This esp includes notifying the family/POA that you're acting upon vague, unwitnessed information. And you also need to let MD know.

Take my word, there's nothing worse than a pt telling family that they fell and nobody helped them! Visitors and other pts freq assist a faller who may not exhibit any injuries at first, so it never gets reported to staff. Then the pt comes up with bruises. pain or immobility. Families will be LIIVID that you're hiding abuse!!! It's just paperwork that admin will followup, so better safe than sorry.

It's obvious from all the responses here that State responses to falls and other situations all depend on location and their own individual protocols.