Mom fell in a small group care facility, more 1 yer 11 months ago, she was left unattended. I was told by someone that I should get legal help before 2 year statute of limitations to see if the care home is liable for any expenses that Aetna did not cover for emergency visit as well as the ambulance. Perhaps even other compensations. The caregivers say they dressed my mom for bed and left her sitting on the bed alone while they left the room to help with others. Hospital bill was about $19,000.00 plus 1200.00 for ambulance transportation. Should I seek help? Are the caregivers and care home responsible? It was my mom's first week that this accident happened.
Both of my parents were in the ER for their fair fare of falls, staying in the hospital for a couple of days. After Medicare paid and the secondary insurance paid, the final bills were quite low. Do you live in the States?
The way I look at what happened, if your Mom was being cared for by a relative in their home and Mom fell in the same manor, would you sue that relative?
If an attorney would not accept this on contingency, then yes, it will get very expensive very fast. Maybe check with a personal injury attorney if there were injuries resulting from the fall.
Is Mom not on Medicare? If so, then if a Medicare hospital they had to except what Medicare considers reasonable. The 20% not covered maybe covered by a supplimental. Same thing with ambulance service if they except Medicare. My Mom never paid more than $500 for a hospital visit.
It can't hurt to try and sue. I would think they have some liability insurance. Try talking to the person in charge and asking if their insurance covers what her insurance didn't. If they aren't forthcoming then consult with a lawyer to see if u have a case.
If you notified the staff and they made sure she was sent to the hospital for evaluation and treatment, what more could they have done? They proceeded with due concern and caution. Again, falls happen even when staff are in the same room.
Would you be suing for negligence? They weren’t- there is no expectation a patient will be literally looked at every minute in a NH & they probably didn’t guarantee this on admission.
Nursing homes and other health care centers have a quality assurance committee that reviews “incident reports”, adverse occurrences in the NH. The NH may or may not have completed an incident report. For you to obtain a copy of this document you will have to retain an attorney to ask the center for a copy as this is an internal document owned by the NH. An attorney can subpoena these records to determine if one was completed but the average Joe (you & I) doesn’t have access without an attorney.
I think a lawsuit initiated by you all now would not be worth it. Thank goodness your mother is still with us. We’re there any residual effects of the fall? Is she now suffering more b/o a fall that occurred 1 - 1 1/2 yrs ago?
Care homes or nursing facilities do not have 24/7 attendants for each resident, so being unattended is common.
Is it possible there was an urgent situation in another room that caused the caregivers to leave the room? Perhaps your mother wasn't ready to lie down?
I would talk with the charge nurse to find out any particulars. There may be notes that can help guide you of any further course of action, either it was an accident and no wrong doing on the part of the facility, or there may be evidence of wrong doing and then you can consult a lawyer.
If you do consult a lawyer, you should have some evidence of wrong doing, unless you want to pay a lawyer's fees to investigate for wrong doing.
You would then have a separate mountain to climb to show that the facility failed in its professional duty of care, and that the harm to your mother was a direct result of their failure.
Besides that, think about it this way.
What do you NEED to achieve? For example: how much money do you still need to find to pay the relevant bills? Has your mother suffered financial loss that will impact on her care going forward? How is she now? - are there improvements in her care or in her quality of life that you would like to make but can't afford to because of the accident?
On top of that, what do you WANT to achieve? It's not unreasonable to seek damages for the pain and distress your mother experienced, for example, not to mention any permanent physical harm. It's not unreasonable, either, to want to make an example of those who fall short of required standards; though there are better, more constructive and more effective, ways of doing that than litigation.
If your mother is now doing well in the same facility, and not at risk of further financial or physical hardship, then I should leave it be.