----- Original Message -----
Sent: Friday, December 26, 2003 7:58
PM
Subject: RE: Definition of a Fall in
writing
This is
directly from the latest update to the MDS 2.0 manual (December 2002).
According to CMS, even if they roll off a bed onto a mat on the floor, and
that is what is care planned for that resident, it is still a fall and should
be noted and assessed, to assure that the plan of care was followed. That is a
specific example in the manual, item d below. You might want to point that out
to your DON and let her know that she is misinformed on this issue. I know
that incident reports were one area that surveyors in WA state focused on last
year and you will want to make sure you are following the latest updates from
CMS..
"Clarification:
Current CMS policy regarding
falls includes:
a) An episode where a resident lost his/her balance and would have
fallen, were it not for staff intervention, is a fall. In other words, an
intercepted fall is still a fall.
b) The presence or absence of a resultant injury is not a factor in the
definition of a fall. A fall without injury is still a fall.
c) When a resident is found on the floor, the facility is obligated to
investigate and try to determine how he/she got
there, and to put into place an intervention to prevent this from happening
again. Unless there is evidence suggesting otherwise, the most logical
conclusion is that a fall has occurred.
d) The distance to the next lower surface (in this case, the floor) is
not a factor in determining whether or not a fall occurred. If a
resident rolled off a bed or mattress that was close to the floor, this is a
fall. The point of accurately capturing occurrences of falls on the assessment is to identify and communicate resident
problems/potential problems, so that staff will
consider and implement interventions to prevent falls and injuries from
falls. In the instance of a resident rolling off a mattress that is close to the floor - even though this is
still recorded as a fall, it might be true that
staff have already assessed and intervened, and that placing a bed close to
the floor to avoid injuries from falls is the intervention that best suits
this individual resident."
Revised--December 2002 Page 3-146 and 147 CMS's
RAI Version 2.0 Manual CH 3: MDS Items [J]
Here is the link to the manual online if you don't already have it
bookmarked.
http://www.cms.hhs.gov/medicaid/mds20/man-form.asp
Deanna J.
Ogle, RN
Care Manager
St. Francis Extended Health
Care
3121 Squalicum
Pkwy
Bellingham, WA
98225
(360)734-6760, ext.
322
[EMAIL PROTECTED]
-----Original Message-----
From: Corey Ali
[mailto:[EMAIL PROTECTED]
Sent: Friday, December 26, 2003 4:19
PM
To: [EMAIL PROTECTED]
Subject: Definition of a Fall in
writing
Some time ago, we had a discussion with a number
of references, regarding that a fall was a nondeliberate change from one
surface to another. I do have the CMS RAI manual definition for my
facility, but the DON and unit managers still insist that if a patient falls
from a bed to a falls mat on the floor next to a bed, that it is not a fall,
and that no record of that event be done in an Accident & Incident report,
etc. It is not covered on the 24 hour sheet, and almost never in the
nursing notes.
Could someone point me to some documentation
indicating that a fall from the bed to a matt next to a bed should be coded as
a fall?
Thank,
Corey
