paramed401

Hello Everyone, I am new to the forum, seeking some insight from experienced long term care nurses. I am a paramedic and an administrator with a local volunteer EMS agency. Our agency is an all volunteer service which is responsible for providing 911 response and emergency transport for the town. We do occasionally get some back up from the county who have a paid staff, but we are the primary provider of emergency medical services in this district. A new long term care facility has just opened in our city. They are an assisted living facility, not skilled nursing. They specialize in memory care, dementia patient populations. The problem that we are seeing is that, despite a relatively low census, we are responding to disturbingly high number of falls at this facility. I have worked for many years in other districts, and our facilities with much higher patient census generate far less 911 calls than this new facility, which has only been open a few months. There have been a couple of emergency calls for other categories, such as chest pain and seizure. But the overwhelming majority is for falls. I am concerned about this for two reasons: 1. I have serious concerns for resident safety if this continues. As an assisted living facility with an LPN administrator, who is responsible for providing oversight? We do not know if there is a consulting RN. I fear that if the local EMS agency does not take notice of this trend, who will? Does this seemingly disproportionate number of falls point to larger issues in this facility, such as staffing or other resident safety issues? 2. It is severely straining our agency's resources. We are being called to this facility several times per shift and our neighboring agencies are having to respond to emergency calls in our district with an extended response time. Most of the time the person has just fallen down, has no complaints, no bleeding, no abnormal vital signs, but they are still required to send them out to the ER. This is happening multiple times per day even. While I understand their liability concerns, they have almost overnight become our single largest caller and their census continues to grow. We asked them in writing before they opened to notify us when they began accepting patients, which they did not do. We are considering several possibilities in dealing with this situation, but don't want to step on toes or go about it the wrong way. We are not out to accuse anyone of anything or get anyone in trouble. Our single overriding objective is the health and safety of all our district's citizen, including those in the LTC facility. So far we see the following options: 1. Set up a meeting with the administrator and express our concerns diplomatically. Request that they create a plan of action to reduce the number of falls in their facility and reevaluate in 90 days. How do you think this would be received? 2. Contact a local regulatory agency for help and ask them to investigate our concerns. The third option, is technically to do nothing. This doesn't seem like the correct or safe option for any of the parties involved What do you guys think? Have you dealt with this type of problem before and are you able offer any other suggestions?