The Minnesota Department of Health (MDH) has completed its investigation of neglect concerns at the Gardens at St. Gertrudes, an assisted living facility in Shakopee, Minnesota. A complaint was filed with the MDH alleging that a client was neglected when the client eloped from the facility during the night and had a fall with injuries. The client had a history of wandering; however, St. Gertrude’s staff only monitored her during the night every four hours.
The MDH investigated the matter and found that the facility did not ensure supervision for the resident’s safety. The MDH found that upon admission to the facility, St. Gertrude’s service plan did not note the resident had a history of wandering. Seven days after the resident was admitted to the facility, the resident walked out of the front door of the facility at 12:16 a.m. Staff checked on the resident at approximately 3:00 a.m. and could not locate the resident. The resident was found lying on the ground unconscious with a heavy bleeding head wound.
The MDH determined that the facility is responsible for neglect of the facility’s resident. [Case no. HL23871003]
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