A March 27, 2014 Department of Health certification survey found Bronx nursing home Concourse Rehabilitation and Nursing Center deficient in numerous areas. One such area was related to keeping the facility as free of accident hazards as possible. The incident documented by the DOH concerned improper supervision of a resident while out of the facility.
The resident involved in the nursing home’s failure was a 79 year old woman with known risks for wandering and elopement, including dementia and severely impaired cognition. Concourse had a wandering care plan in place for the woman. During a routine trip to the hospital for an appointment, the resident wandered from the waiting room despite the fact that she was accompanied by an escort. The escort and the resident both went to use the bathroom. When the escort came out, the resident had left not only the bathroom but the hospital itself. Staff of the nursing home searched for the resident at both the home and hospital, but were unable to locate her. Not until later that night was the resident found by her granddaughter. The report does not state where she eventually found her grandmother. Additionally, although the report does not specify whether she was fired or left of her own volition, the CNA escort is no longer employed by Concourse.
Many elderly nursing home residents are admitted with cognitive impairments that make them risks for wandering and or elopement. Proper care plans can minimize the risk that these events occur, but only if the care plans are followed. When left to fend for themselves, elderly individuals with reduced mental capabilities are at greater risk for dangerous accidents, such as falls and fractures. An accident resulting in a fall can also lead to increased cognitive decline, in addition to the obvious physical injuries that can result.
Fortunately the resident appears to have been unharmed as a result of her wandering from the hospital. This incident is a reminder that while proper care planning is essential to the care of elderly nursing home patients, the execution of the care plan is equally, if not more, important.