Nursing Home Incident Reports

If your loved one has been injured in a nursing home and there does not seem to be a reasonable explanation from the nursing home, go to the administrator and request the incident report. Most nursing home policies require that the staff member treating the resident at the time of the incident prepare a statement to describe what happened. For a family member, determining how an incident occurred can be very difficult. The resident often cannot describe or remember how or even if she fell, chocked or suffered burns for example. The family has to rely on the nursing home and its care givers to tell them what happened.

Almost all nursing homes’ policy and procedure manuals require the nursing home to conduct an investigation to determine the cause of an incident.

Those policy and procedures require the nurse caring for the patient to report the incident first. Once that reporting is done, someone is assigned to investigate. The purpose of these investigations is not to accuse or even to deny, but to find out what happened and to prevent future occurrences if possible. Those policies usually require that a pre-printed form be employed to investigate the incident. Each nurse on the shift is to be interviewed and those that have pertinent information are to document the event- usually with a written statement. Then the interdisciplinary team- a group comprised of care givers including nurses, therapists, activity directors, and dietary personnel will review the statements. Again, the purpose of this review is to protect and help all residents. In addition to all this, most policy and procedures require that the nursing staff do a post incident assessment. This assessment is designed to help the nursing staff determine not only what happened, but what factors created the condition which caused the incident. All of these reports are shared throughout the facility. The ultimate goal is to provide care givers with information so that preventable similar incidents will not occur in the future.

You should get this information in an incident involving your loved one. Often the policy and procedures require that the resident is entitled to a copy of the incident report. Likewise, his personal representative is entitled to a copy. If the nursing home has not performed an incident investigation and made a report, request that they do so immediately. If they still have not performed an investigation or do not provide a copy of the incident report to you, file a complaint with the regulatory authority in your state. In most states that is the department of public health.

Even when a matter ends up in litigation, problems arise trying to get these investigations. Attorneys who represent nursing home residents will request copies of these records to learn the names of personnel involved, witnesses, status of the patient, and obtain a review of the incident close in time to its occurrence. That is when witnesses’ memories were fresh and untainted by time and the influence of supervisors and defense lawyers. Almost inevitably the nursing home will take the position that these records are not to be produced because of a perceived attorney client privilege, work product privilege, or quality assurance protection. Most of the time an attorney can file a motion to compel production of these records and the court will make the nursing home provide them. If the family can get a copy of the incident report before an attorney has to request it, the details of the event are know and decision can be made whether there was nursing home neglect or abuse before a suit needs to be filed. Getting the report early is better for everyone.