What are the obligations of an assisted living facility if my mother was injured there?

A fellow caregiver asked...

My mother is in an assisted living facility specialized for Alzheimer's patients. The unit allows for freedom of the patients to move around as they wish with little supervision. About a week ago my mother was walking in the hall of her unit and went into the room of another patient. The patient got aggressive and pushed my mother down and broke her hip. She will not be able to return to this facility as she will probably not be able to move around on her own. My mother is still in the hospital recovering but I am wondering what are the obligations of the facility in regards to future care. The incident report clearly lays out that my mother was pushed down and broke her hip. An attending LPN put her in a wheel chair then put her into her bed before calling for an ambulance. Any advice would be helpful.

Expert Answer

Carolyn Rosenblatt, R.N. and Attorney is the author of author of The Boomer's Guide to Aging Parents. She has over 40 years of combined experience in her two professions. As a nurse, she has extensive experience with geriatrics, chronic illness, pain management, dementias, disability, family dynamics, and death and dying. As a trial attorney, she advocated for for the rights of injured individuals and neglected elders. She is also co-founder of AgingParents.com.

Your question about your mom's assisted living injury raises the issue of whether the facility is able to protect its residents. Legally, assisted living facilities are in a somewhat problematic position. They fill the gap between being at home, which is usually unsafe, and being in a nursing home, which generally has registered nurses and other licensed personnnel on staff to provide skilled care. In this treatment gap, the level of supervision is less than in a nursing home.

I am not able to address whether the facility is potentially liable for the situation of failing to supervise the aggressive resident and simultaneously allowing your mother to wander into that resident's room. The question of what was done to her before the ambulance was called is also an issue. If you wish to explore these questions, you should seek the advice of an elder law attorney who litigates elder neglect cases in your state and in the county where the injury occurred. Often, this kind of initial legal evaluation may be at no cost to you, though you may be required to pay for getting a copy of all the relevant records, including the records of treating the fracture. There are legal time limits, so act promptly to protect any rights she may have.

You ask what the facility's obligations are for the future. I presume you mean a facility, in general, and not the one where she fell, as she's not going back there. Any facility where you next place your mother must be able to provide appropriate care and supervision for your mother, who is a wanderer, and who has now a history of putting herself in danger. I suggest you find a more secure environment than the one she was in previously.

Unfortunately, assisted living has legal limits, and I've written a lot on this subject, some of which is in articles on my website. In a nursing home that accepts Medicare and Medicaid, there are many rules for resident safety and supervision which do not apply to assisted living facilities. Ask questions and learn what the differences are between skilled care and assisted living, even when assisted living specializes in "memory care". Your job now is to find a place that will do more in addressing the wandering problem and won't allow her to move about without greater supervision. See the hospital discharge planner to explore your options now, before your mom's discharge is imminent.