Nursing Home Fails to Ensure Resident Safety During Transportation

This case takes place in North Carolina and involves a paraplegic male patient who was a resident at a nursing home. The nursing home had an existing arrangement with a third party transportation service to transport its residents to destinations within the local area. On one occasion, the transport company failed to properly secure the patient while transporting him to church. During the transport, the driver made a sharp turn, which caused the patient to fall from his wheelchair, which resulted in significant injuries to the patient’s head, neck, and shoulders. The patient’s recovery was long and difficult, placing a significant financial burden on his family. The plaintiff in this case sought an expert in nursing home administration who can speak to the non-delegable duties that a nursing home has regarding the transportation of its residents to medical appointments.

Question(s) For Expert Witness

1. Please discuss your background in nursing home administration.

2. What are the obligations of the nursing home, as it relates to patient's safety, when contracting another party to assume the duties of transportation?

3. What could have been done to avoid the outcome for this patient?

4. Have you ever served as an expert witness on a case similar to the one described above? If so, please explain.

5. Please tell us why you’re qualified to serve as an expert reviewer of this case.

Expert Witness Response E-015234

I have been involved with nursing home administration since 1983. Transportation is often "delegated," but facility is always responsible for professional level transportation. The nursing home's obligation to patient safety is outlined in F500 483.75(h) Use of Outside Resources*. I have served as an expert on a similar case in the past as well. I have published the book "federal Requirements and Guidelines to Surveyors" in its 8th edition, that outlines this responsibility and duty of the nursing home very clearly. (1) If the facility does not employ a qualified professional person to furnish a specific service to be provided by the facility, the facility must have that service furnished to residents by a person or agency outside the facility under an arrangement described in section 1861(w) of the Act or an agreement described in paragraph (h)(2) of this section. (2) Arrangements as described in section 1861(w) of the Act or agreements pertaining to services furnished by outside resources must specify in writing that the facility assumes responsibility for-- (i) Obtaining services that meet professional standards and principles that apply to professionals providing services in such a facility; and (ii) The timeliness of the services.