An elderly, female nursing home patient with dementia and a history of exit-seeking behavior was admitted to a nursing home’s secure/locked unit to protect her from falls, wandering, and elopement. After a short period on the secure/locked unit, the nursing home moved the patient to a portion of the facility that was not locked. On the unlocked unit, the patient was noted to be “going down to the back doors trying to get out” and to have “went out the front doors,” without supervision. Nursing home staff later watched the patient push “open the door at the end of the hall” in an effort to exit the building without supervision. The patient later actually exited the building and was found in the parking lot without any staff nearby for supervision. Despite attempted and successful exit-seeking by the patient, the nursing home never provided the patient with an alarm (e.g. Wanderguard) to prevent wandering/elopement.
Within one week of the last of these episodes, a visitor entered the nursing home and shouted the patient was “out in the parking lot.” The patient had again been permitted to exit the building without supervision and rolled down a steep hill in the parking lot toward the road. The patient was found lying in a graveled area near the bottom of the parking lot, conscious but bleeding from her head. As a result of the fall, the patient sustained numerous, severe facial fractures and subarachnoid hemorrhages. The patient was transferred to a local hospital, where she remained in the intensive care unit until her condition stabilized. She was transferred to a transition unit at the hospital for rehabilitation thereafter. After discharge from the hospital’s rehabilitation unit, the patient’s family returned her home for further supportive care. The patient and the patient’s family later sued the nursing home based on the facility’s failure to supervise to prevent wandering, elopement, and other exit-seeking behavior and failure to provide the patient with exit alarms that would notify staff before the patient exited the building. The nursing home settled the case for a confidential amount in the high-six figures.
