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Giant snowbanks lead to accidents, parking complications

Monster snowbanks that block your line of vision to oncoming traffic. Ice flying off big rigs and landing on your windshield. Mounds of sidewalk snow spilling into your parking spot. The list of driving-related snow woes this season goes on.

“The town does its best to get all the snowbanks down, but you can’t get all of them down,’’ said Donna McKenna of Hopkinton. “I’ve noticed people flashing their headlights when coming out of a side street to let people on the main street know they’re there, particularly at night. I just thought that was a great idea.’’

With all the snow we’ve had this winter, it’s easy to feel as if we’ve seen it all. But as McKenna points out, even with a dozen storms under our serpentine belts, there’s more to learn.

Take giant snowbanks. If you hit another car because your view was blocked by a snowbank, will your insurance rates go up?

Most cities require you to park within a foot of the curb, but does that rule still apply during this crazy winter, where curbs are buried thigh-high in snow?

Is a truck driver — or any driver — required to scrape off rooftop snow? If your car gets hit by a snowy projectile that blows off another vehicle, are you responsible for the damage?

This column was supposed to have been about running out of gas, but these days, snow takes precedence.

Can’t see The story was just a few paragraphs long. “Two injured after crash in Hopkinton; snowbank to blame,’’ read the MetroWest Daily News headline. But what got my attention was that police didn’t cite the driver who caused the accident, apparently because the offending snowbank would have blocked a giraffe’s view.

“We use our judgment in a lot of cases,’’ Hopkinton Police Chief Richard Flannery told me. “If it’s a situation where our officers don’t think a clear violation has occurred, they’ll document the individual’s statement and let the chips fall where they may with the insurance company.’’

So will the unnamed driver who caused the accident be hit with a surcharge? You bet he will, insurance experts said.

In Massachusetts, insurance companies must abide by the state’s Standards of Fault list when assessing accident claims. The list, which appears in the Code of Massachusetts Regulations, cites types of accidents in which a driver is automatically surcharged, regardless of mitigating circumstances. For example, if you rear-end someone or hit a parked car, you’re automatically found at fault. Hitting another car while emerging from a driveway or side street also triggers an automatic surcharge.

The Standards of Fault don’t allow leeway for accidents influenced by bad weather, nor will you find any mention of snowbanks or icy roads in the law, said McKenna, who is also a spokeswoman for the Massachusetts Association of Insurance Agents.

Even if your insurance company wanted to pay your entire claim, legally, it can’t, she said.

“Insurance companies can’t just say, ‘Well, it was snowy, so we won’t charge you,’ ’’ McKenna said. “They have to find fault based on the standards.’’

The good news is you can appeal, and if bad weather or snow led to your accident, you have an excellent chance of winning. “I don’t know anybody who appealed a weather-related accident who didn’t have the surcharge overturned,’’ she said.

To prepare for an appeal, McKenna advised, take a photo of the snowbank, preferably with a person or a car next to it to add perspective. Copy the day’s weather report, and obtain a copy of the accident report. “And put together all of your thoughts as soon as possible, as it may be hard to recall them by the time you have your hearing,’’ she said.

Expect to wait months for your hearing, and know going in that even if you win, the state’s $50 appeal fee is nonrefundable.

Rule’s a rule The knock on my front door was loud and determined, just what you’d expect from a Somerville police officer.

“You need to move your car,’’ he said politely. “If a firetruck comes down the street, he won’t be able to make the swing.’’

As driving is my business, I know that when parking on the street, I’m supposed to leave a width of 10 to 12 feet for a firetruck to pass. I felt I’d done that, but there was an issue: Because of a snowbank spilling into the street, I was parked several feet from the curb.

Under normal circumstances, you’re never supposed to park more than a foot from the curb. But the snow bank — which I didn’t put there — would have taken days to shovel out. Given that every other parking spot within a three-block radius of my home was taken, was I seriously expected to obey the 1-foot rule?

“Just because there is snow, that doesn’t change the parking regulations,’’ said Michael Meehan, Somerville director of communications. “We understand it’s difficult in some areas, and we’re not going around with a ruler handing you a ticket if you’re over a foot away from the curb . . . but people still have to get down these streets.’’

My guess is the policy applies no matter where you live. Boston parking officials said they’ve ticketed more than 200 drivers $35 each for parking too far from the curb this winter. The cars blocked road access to emergency vehicles and plow trucks, they said.

I moved my car, but Kevin Robinson, president of the Fire Chiefs Association of Massachusetts, told me he had yet to hear of an instance this winter where a firetruck couldn’t fit down a street to respond to a call.

Nevertheless, he urged drivers to remember most firetrucks are 10 feet wide, including mirrors, so you should leave at least 12 feet to let one pass, even if your community, like Boston, technically requires just 10 feet of access.

“If you’re only giving us 10 feet we’re really going to be slowed in our response,’’ Robinson said. “Most engine trucks are 28 to 30 feet long, so on corners we need even more room.’’

We’ll cover flying snow another time.

Source:  boston.com


Nursing Home Negligence

Falls in Nursing Homes

Litigators who work with cases involving long term care know how significant the issue of falls can be. Falls are the leading cause of injury and death by injury in adults over 65. Approximately half of the 1.6 million nursing home residents in the U.S. fall each year, and a report by the Office of the Inspector General found that about 10% of Medicare skilled nursing residents experience a fall resulting in significant injury; and, more than 1/3 of hospital falls result in injury. In the rehab setting, rates are often higher – for example, fall rates among stroke patients have been shown to be very high. Immobility and falls can lead to poor outcomes.

Fear of falling is defined as a geriatric syndrome. It not only occurs in older adults who have fallen, but in those with impaired mobility and is associated with decreased physical ability and depression. Care of older adults requires that clinicians be aware of the myriad of issues related to falls including knowledge of this syndrome, increased risk and interventions needed to prevent injury related to falls.

Just about every resident in a long term care setting, including assisted living and sub-acute rehab, is at risk for falling. Between medications, functional and medical issues and advancing age, older adults in most settings are prone to falling.

There are well established standards of care related to fall prevention; but, as I continue to review records related to issues like falls, I am amazed at how often these basic standards are not being practiced. The basics of a fall prevention program include assessment and ongoing reassessment of risk, ensuring a safe environment, medication review, providing therapy as needed, individualized interventions, and staff education.

Basic nursing practice includes assessment, planning (Care plan), putting interventions in place and then evaluating outcomes to determine if those interventions are appropriate and effective. Assessment includes completing fall risk assessments on admission and then as needed. Very often, the fall risk assessments completed by nurses in LTC are inaccurate. The tools utilized in long term care typically include these risk factors: history of falling, use of ambulatory aids, gait/balance issues, medications, secondary diagnoses (i.e. diabetes) and mental status. Care planning is the next step in nursing care - it is the standard of care that as the resident’s status changes, assessments and care plans must be updated, and often, are not. For example, with each fall, there should be updates, or if there is a new diagnosis, i.e. stroke, or worsening dementia, updated interventions should be put into place, with ongoing evaluation of effectiveness.

Care planning and interventions very often are generic and not individualized. For example, a toileting schedule that includes only after meals and before bedtime may not be appropriate. If a resident has issues with constipation or incontinence, this may lead to the need for more frequent toileting to prevent falls. The “make certain call bell is within reach” for residents with dementia is an example of a generic intervention. Older adults with dementia may not recognize a call bell or remember to use it. The debate about use of bed and chair alarms go on – they are a part of an individualized care plan, not a solution to preventing falls. Often, I see delays in putting interventions in place, i.e. with the resident who is incontinent NOT being put on a toileting plan immediately. The other common issue I see when reviewing records is the lack of updating care plans as the resident’s status changes – with every fall, with worsening dementia, physical decline, or new medical diagnosis (i.e. Parkinsonism).

Nurses reviewing records need to pay attention to the MDS, risk assessments, care plans and Interdisciplinary notes with attention to where the standard of care is not being met.
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6 days ago  ·  

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