March Featured Scenario F-323 Free of Accident Hazards/Supervision/Devices: ELOPEMENT

In this annual/extended survey and complaint investigation, the facility failed to provide adequate supervision to prevent four of six sampled residents assessed as being at risk of elopement from successfully exiting the facility without staff knowledge. This resulted in Immediate Jeopardy when four residents eloped from the facility and the likelihood of harm for the additional 65 residents identified for elopement risk. On 01/08/10 and on 01/22/10, the administrator and director of nursing (DON) were notified that Immediate Jeopardy (IJ) began on 04/18/09 when Resident eloped from the facility after he gained access to the security code by watching as it was entered into a keypad. Immediate Jeopardy remains ongoing because the facility failed to provide adequate supervision to prevent residents identified as being at high risk of elopement from leaving the facility without staff knowledge. Facility was cited at a K level.

What actions would you and your staff members take to prevent this from occurring in your facility?

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