Hemet Valley Healthcare Center D/P Snf
371 N. Weston Place, Hemet, CA 92543
Citation Number: 250005326
Citation Date: 8/20/2008
Violation Date: 1/8/2008
Class: AA
Penalty: $ 100,000

A day after admission, an 81 year old resident hit her head while receiving therapy and suffered an injury that led to her death. The therapist did not report the head injury to the nursing staff even though he knew the resident was taking two blood thinning drugs that put her at increased risk of internal bleeding. Her son reported his mother's injury to an LVN that evening. The LVN failed to perform necessary neurological assessments, but did inform an RN of the head injury. The RN was subsequently fired for failing to assess the resident or to notify her physician. The facility failed to notify her physician even after her blood pressure dropped the next day. She became unresponsive, was hospitalized about 34 hours after the head injury, put on life support and died two days later. The cause of death was an intracerebral hemorrhage. The facility was cited because its failures were a direct proximate cause of the resident's death.