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SeniorCare
ProAssurance Risk ManagementAugust 20212 min read

Assisted Living Facility Settled Resident Fall Claim Amid Uncertain Duty of Care

Allegation

A resident’s injury while being transferred to a wheelchair resulted in declining health and raised questions of duty of care at the independent apartments of an insured assisted living facility.

Case Details

The resident, a 90 YOF (5’5”, 184 lb), had a history of diabetes, osteoarthritis, hypothyroidism, and multiple prior falls. Notes from the insured facility indicated the resident was partial non-weight bearing, and needed assistance with transfer to a wheelchair or walker. Notes also indicated the resident required a significant amount of assistance with activities of daily living (ADL).

The resident was a long-term tenant of the insured assisted living facility’s independent apartments. The apartments did not provide skilled nursing care. The agreement between the resident and the facility was that the facility would provide housekeeping services and help prepare food, but would not assist with ADLs. The resident was to arrange for her own care providers for any assistance with ADLs.

The resident had a history of bad behavior with staff, which included making unreasonable demands, bossing them around, and threatening to sue the facility anytime she did not get her way. In an effort to accommodate the resident, the facility agreed to allow the staff assigned to her apartment to help position her walker and wheelchair next to the bed when the resident got in and out of bed once a day. The facility instituted a policy requiring two caregivers to be present during every interaction with the resident due to her unreasonable behavior.

During the incident in question, two staff members placed the resident’s wheelchair and walker next to her bed, as directed. They were holding the wheelchair and walker when the resident attempted to transfer from her bed to her wheelchair. She made it clear she was not to be touched. While attempting to transfer, she stood, lost her balance, and sat back on the bed. She was unable to readjust her position. The resident slid down to the floor. She was transferred to the hospital and did not return to her apartment managed by the insured facility.

The resident informed the hospital’s staff during hospital intake that she did not fall. She said her left leg twisted, she heard a pop, and felt pain right away. An x-ray showed a left intertrochanteric hip fracture closed and mildly displaced. The x-ray also showed an impacted, nondisplaced, subcapital right femoral fracture from a prior fall.

Due to comorbidities, surgery was delayed four days. Once cleared, her left hip fracture was repaired. The resident was discharged to a skilled nursing facility five days after surgery. While at the facility, the resident’s condition continued to decline, and she developed a number of wounds at different stages of severity. Fifteen months after the incident at her apartment, the resident was transferred to a different nursing home.

Resolution

Initially the resident insisted her injury occurred through no fault of the insured facility; she later filed suit alleging negligence and malpractice. Due to questions stemming from duty of care, the case was settled for an undisclosed amount.

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