Disproving Understaffing in Fall Claims

According to the National Council on Aging, Americans aged 65 and older have a one in four chance of experiencing a fall during each calendar year. With falls being the leading cause of fatal and non-fatal injuries for the elderly1, it comes as no surprise that they are also consistently identified as a leading claim category at facilities who serve an aging and frail population.2

Despite the fact that falls occur both in and out of care settings and in low and high-risk populations alike, nursing homes are often blamed when falls happen under their watch. Plaintiff’s attorneys use a variety of information sources when building a case for medical negligence, carefully considering medical records, care plans, and staffing reports. Their goal is to prove that the nursing home did not provide an adequate level of care to the resident and that it was their lack of attention that led to the fall.

Facilities who need to defend themselves against allegations of understaffing as a root cause of neglect can do so using their own staffing data. Each month, nursing homes are required to submit their payroll-based journal (PBJ) information to the Centers for Medicare & Medicaid Services (CMS) website, which is publicly available for anyone to view and extract. If a facility was adequately staffed during the specific period of time when a fall occurred, the numbers on the CMS website can provide proof. However, it does take time and effort to mine through the lines of data and then format the information into a useful tool.

The Staffing Scorecard Solution

Excelas developed the Staffing Scorecard to give our clients quick access to their PBJ staffing data in an easy-to-read format that allows them to:

  • View the number of direct care hours per patient, categorized by job title.
  • Compare their facility’s staffing levels to nearby competitors.
  • Monitor their staffing trends over time so they can detect any issues.

If allegations of negligence arise, the Staffing Scorecard shows whether or not there were fluctuations or inconsistencies in staffing levels during a certain period of time. When the scorecard is combined with our medical chronology, facilities can further identify the level of care provided during significant medical events.

To find out more about Excelas’ Staffing Scorecard, contact us today for a free consultation using the form below.

1 https://www.ncoa.org/news/resources-for-reporters/get-the-facts/falls-prevention-facts 2 CNA Aging Services 2018 Claim Report; Valuing Employees, Minimizing Risk

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