Monday, February 16, 2009

Patient Dies After Being Caught in Bed Rails at Berwyn Rehab

Berwyn Rehabilitation Center
3601 South Harlem Avenue, Berwyn
Fined- August 25, 2008
Berwyn Rehabilitation Center was fined $50,000 for an incident where established precautions were not taken to prevent a resident from becoming wedged between his bed rails and mattress, resulting in his death.
On investigation, surveyors learned that despite the fact that the resident demonstrated unsafe behaviors, including banging on the side rails and trying to get out of bed while the side rails were up, the nursing staff neglected to communicate observations of the resident’s behaviors amongst themselves or observe policies designed to keep him safe.
In particular, a vendor was allowed to replace the approved bed rails with rails that had been prohibited for this resident. Shortly afterwards, the resident was found unresponsive, having gotten caught between the prohibited bed rail and the mattress.

No comments: