Nursing Home Liability for Failure to Follow Care Plans After a Fall

Falling is a leading concern for residents in long-term care. Many residents are frail for age-related reasons, making them more prone to having a fall. For others, however, the risk is greater because of an underlying medical condition that may make the consequences after a fall more dangerous.

PKSD explains more about nursing home care plans, including what they are and whether a nursing home may be liable for failing to follow a resident’s plan of care after a fall.

If your loved one in long-term care suffered damages due to negligence after a fall, we are prepared to help. Our Wisconsin nursing home abuse lawyers are compassionate and dedicated to protecting the rights of elderly residents. Our strong and proven track record speaks volumes of how hard we work for our clients.

Call our trusted law firm for legal help. 414-333-3333

What is a Nursing Home Plan of Care?

A nursing home plan of care is like a road map for caregivers to follow. It is written to address each resident’s current and unique needs, abilities and health concerns. Under federal law, a resident’s plan of care must:

• Have measurable objectives
• Include timetables
• Be specific
• Periodically be reassessed and revised
• Be in writing
• Reflect the resident’s needs and concerns

Broad care statements are not acceptable in a plan of care. This is necessary since much of a resident’s daily care is handled by staff who are not a trained doctor or nurse. Therefore, directions need to be clear enough that anyone can understand them. They also must be detailed so that a resident feels like his or her needs are being considered and met.

How Are Needs Assessed or Reassessed?

Wisconsin nursing home residents must have an initial health assessment completed within four weeks of admission. The resulting initial care plan must include assessments from the patient’s doctor and all other appropriate professionals from the facility. Follow-up assessments must occur periodically to ensure there are no changes. Information that should be considered, include:

• The specific medical, health or personal services the resident needs
• Type of staff needed to administer these services
• How often those services are needed
• Any special equipment or supplies that are required
• Special dietary needs a resident may have, along with food preferences

A mobility assessment will take place upon admission to determine if a resident is a fall risk. If a resident presents with mobility issues, the facility may add protection or interventions to reduce the risk of a fall.

Some residents may have additional concerns to check for after a fall because of an underlying medical condition or prescription drugs they are taking. For example, patients on blood thinners should be carefully monitored for a subdural hematoma (brain bleed) if they fall and hit their head.

Do Family Members Have Input into a Resident’s Care Plan?

Family members are encouraged to participate in their loved one’s care plan meeting. This meeting discusses what a resident can expect on a day-to-day basis, including meals, medical and nursing needs, and more. The professionals who will be providing daily care for your loved one (nursing assistants, doctors, physical therapists and nurses) will also attend and have input into this meeting.

Liability if a Plan of Care is Not Followed After a Fall

To determine liability, an attorney will need to investigate and determine if an initial assessment was done. If an assessment was done, it is also necessary to determine whether the plan of care was created, communicated to facility staff and properly followed.

Other factors to consider that could help determine if a nursing home is liable for a resident’s fall and subsequent injuries:

• Was the resident known to be a fall risk and if so, did the facility take preventative measures to reduce that risk?
• Did nurses, nursing assistants and other facility staff treating the resident properly follow his or her plan of care?
• After the fall, was there a re-evaluation of the resident’s care plan to determine if changes were needed?
• Were there any environmental hazards, such as a wet floor left unattended, that led to the fall?
• Did the care plan document any known physical, mental or health issues that made walking without help difficult?
• Was the resident on any medications known for side effects, such as dizziness, that could increase the risk of a fall?
• Did staff follow proper procedures after the fall, including evaluating and monitoring the resident?
• Did the facility follow up to investigate the cause of the fall and implement interventions to ensure it did not happen again?
• Was the fall, including the circumstances, resident outcome and caregiver response, properly reported?
• Did the facility alert the resident’s physician, and did the physician properly examine and monitor the resident?

If your loved one suffered a fall in a nursing home, it is a good idea to speak with a qualified attorney about your situation. If you have a case, he or she will investigate the circumstances that caused the fall and whether the nursing home acted appropriately afterward. If a nursing home is found negligent in the care of your loved one, you may be eligible to seek damages on his or her behalf.

Common Injuries Caused by Nursing Home Falls

Falls in nursing homes often result in devastating injuries, especially for residents who are elderly or have fragile health conditions. Even a short fall can cause permanent harm or lead to a rapid decline in overall health.

Some of the most frequent injuries include:

• Hip and Pelvic Fractures: These injuries often require surgery and can severely limit mobility.

• Head Trauma: Falls can lead to concussions or dangerous brain bleeds, particularly in residents taking blood thinners.

• Broken Wrists and Shoulders: Many residents instinctively try to break their fall, resulting in upper-body fractures.

• Internal Bleeding: Hidden injuries may go unnoticed and become life-threatening if untreated.

• Emotional Trauma: After a fall, residents often experience anxiety or depression, making them fearful of walking or moving without help.

Families should ensure that any fall, no matter how minor it appears, is promptly assessed by medical professionals and documented in the resident’s care record.

How Nursing Homes Should Prevent Falls

Preventing falls is one of the most important responsibilities of nursing home staff. Every resident’s care plan should include clear strategies tailored to their physical and cognitive condition.

Effective fall prevention measures include:

1. Regular Risk Assessments: Conducted during admission and after any significant change in medication or health status.

2. Environmental Safety Checks: Keeping hallways clear, ensuring adequate lighting, and using non-slip flooring.

3. Proper Staffing Levels: Having enough trained caregivers to assist residents with transfers, mobility, and toileting.

4. Use of Assistive Devices: Providing walkers, wheelchairs, and grab bars when necessary.

5. Medication Monitoring: Identifying drugs that increase dizziness or confusion and adjusting doses appropriately.

A facility that fails to implement these protections may be violating state and federal standards of care.

Why Care Plans Fail in Nursing Homes

When a nursing home fails to follow a resident’s plan of care, the cause is rarely a single oversight. In most cases, it results from systemic problems within the facility.

Common reasons include:

• Understaffing: With too few caregivers, employees are often rushed and unable to provide proper supervision.

• High Turnover Rates: New staff may not be properly trained on a resident’s specific needs.

• Poor Communication: Gaps between nurses, aides, and administrative staff can lead to missed care steps.

• Incomplete Documentation: If care plans are not updated after health changes, staff may unknowingly use outdated instructions.

• Lack of Accountability: When management fails to enforce compliance, preventable errors become routine.

Families have the right to question how their loved one’s plan of care is being managed and whether the facility is meeting its obligations.

Federal and State Regulations on Care Plans

Federal and Wisconsin laws require nursing homes to maintain and regularly update individualized care plans for each resident. These regulations are in place to ensure that every patient receives consistent, high-quality care.

Federal Regulations:
Under the Nursing Home Reform Act, every resident must have a written care plan developed within seven days of admission. This plan must:

• Identify specific medical, nutritional, and mobility needs

• Include measurable goals and interventions

• Be reviewed at least once every 90 days or after any significant change in health

Wisconsin State Requirements:
The Wisconsin Department of Health Services (DHS 132) enforces additional rules that require:

• Reassessment after falls, injuries, or new diagnoses

• Documentation of staff communication and response times

• Compliance with resident rights and safety protocols

If a facility fails to meet these standards, it can face penalties, fines, or loss of licensure.

What Families Can Do if a Care Plan Is Ignored

If you believe your loved one’s nursing home has failed to follow their plan of care, swift action can help protect them and prevent future harm.

Here are the steps to take:

• Request Documentation: Ask for a copy of the care plan, fall report, and any incident or medical records.

• Meet with Facility Leadership: Discuss the incident directly with the administrator or director of nursing and request corrective action.

• File a Complaint: You can contact the Wisconsin Division of Quality Assurance (DQA) to report neglect or care violations.

• Speak with the Ombudsman: The Wisconsin Board on Aging and Long-Term Care can help mediate disputes with the facility.

• Consult a Nursing Home Negligence Attorney: If your loved one was injured, an attorney can help investigate, preserve evidence, and pursue compensation for medical costs and suffering.

Holding nursing homes accountable not only helps your family seek justice but also helps prevent similar harm to other residents.

Call PKSD for Experienced Nursing Home Legal Help

At PKSD, we work tirelessly to hold at-fault parties accountable for acts of negligence and have been doing so for decades. We have extensive experience handling cases involving nursing home abuse and negligence, recovering millions on our clients’ behalf. This recovery record includes a $4.6 million settlement in a nursing home pressure sore case.

If you suspect your family member has been harmed by negligence in his or her nursing home, we are ready to help. Contact our law offices to set up a case review with one of our qualified attorneys. There is zero cost for this initial meeting, and if we represent you, there is also nothing to pay up front. We take these cases on contingency, so unless we win compensation for you, we do not collect our fees.

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