Does Mom's nursing home hold responsibility for her fall? And can we take her for a weekend?

1 answer | Last updated: Oct 28, 2016
Ron s. asked...

My 80 year old mother is a nursing home. She initially went there (April 2008) to rehab a groin muscle tear suffered during a fall at home. The 3-week rehab was going very well until she fell during the night in the nursing home and fractured her hip.

She required surgery (screws?) to repair the fracture and suffered a minor stroke during the operation. This rehab has not gone so well as she barely gets around with a a walker and requires 24 hour supervision.

Medicare covered the first 100 days in the home. Now she is paying on her own...about 8K per month. Ouch. Should the home (a Medicare approved facility) or Medicare be responsible to pay since she fell while under their care and caused her to have to stay beyond the original acute care for the groin injury?

She also has no or very little signs of dementia. Her only problem is getting around, especially to go to the bathroom, transfer from bed to walker or wheelchair, etc.

We have asked the home if we (children) can take her out for a weekend or extended stay but they say, "no...if anything happens, Medicare won't pay". I have replied, "well she fell while under your care and Medicare is not paying now so what's the difference!" We just want to get her out of there once in a while to lift her spirits and give her some different stimulation. Many/most of her fellow residents are serious dementia patients and offer little interaction.

Any suggestions you can provide would be appreciated.
(she was fine before)


Expert Answers

Barbara Repa, a Caring.com senior editor, is an attorney, a journalist specializing in aging issues, and the author of Your Rights in the Workplace (Nolo), now in its 10th edition.

Injuries and diagnoses being what they are, it would be difficult for you to prove that the nursing home caused or was even responsible for the hip fracture that seems to have been a setback for your mother.

But what comes through loudly and clearly is that you're unhappy both with the care your mother is currently receiving"”and with the way the staff and administration are handling your questions and concerns about her care.

Try contacting the facility's ombudsman for help. He or she is an independent worker whose main task it is to make sure that nursing home residents' rights are properly enforced. Most of them are also skilled mediators"”and know the ins and outs of a particular nursing home and what steps might be taken to right a wrong situation. You can find out the name of the ombudsman at the particular nursing home by contacting The National Long-Term Care Ombudsman Resource Center at www.ltcombudsman.org.

If, after appealing to the nursing home staff, administrator, and ombudsman, you are still unable to get the help you need and the care that your mother needs, consider the somewhat drastic step of moving her to another facility. For many people, this is a lifesaver.