He was told to call 911 for an ambulance — to come to the hospital.

Wallace’s son said the pair was roughly 150 feet from the hospital’s own emergency department at the time. So Wallace stayed on the metal grate where she had fallen, while the guard gave her a blanket to rest her head on and some paper towels to clean up the blood from her cuts.

And there she waited. For another 30 minutes.

Eventually, an orthopedic surgeon saw what had happened and got another staffer to help move Wallace into a wheelchair. Soon after, an ambulance from another local hospital arrived to treat her.

A spokesperson for Greater Niagara said the incident stemmed from a communication problem. Employees have since been trained on how to handle similar situations and the hospital is reviewing the incident.

Wallace said all she really wants is an apology, which still hasn’t been offered.

Notably, this isn’t the first time Greater Niagara employees have had some confusion over how to handle sudden emergencies.

Last April, a 39-year-old woman died shortly after being turned away from Greater Niagara’s ER. Her boyfriend had driven her there after she fell unconscious and stopped breathing. He was also told to call 911.

A few months later a local politician with a history of health problems was semi-conscious when she was brought to the ER by her husband. They were also told to call for an ambulance.

The incidents apparently stemmed from an erroneous belief by some employees that insurance wouldn’t cover any treatment unless it was provided in the actual hospital building and not the ER.

A new report from the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) says those efforts don’t — and possibly can’t — do much to prevent falls.

Many of the factors that contribute to a fall aren’t preventable — or at least aren’t anything the admitting hospital can address: conditions such as Parkinson’s and delirium, dizziness and vertigo, osteoporosis and stroke.

The study’s authors say that if the falls aren’t preventable by the hospital, then hospitals shouldn’t be held responsible for them as they currently are. (Hospitals are required to have fall prevention plans in place, and CMS classifies preventable falls as non-reimbursable.)

Obviously, hospitals need to make common sense efforts to reduce fall risk such as warning patients and keeping patient areas clean, accessible and safe. But is requiring more than that asking too much? Share your thoughts in the comments.

Reported events Jan.1 through Sept. 30, 2009:

• Wrong-site surgery — 126
• Unintended retention of foreign body — 97
• Delay in treatment — 94
• Operative/Post-op complications — 79
• Suicide — 72
• Patient fall — 65
• Medication error — 34
• Assault, rape or homicide — 27
• Perinatal death or loss of function — 26
• Patient death or injury in restraints — 9

Since JCAHO started tracking sentinel events in ’95, more than 6,500 patients have been affected, with 68% of the events resulting in death.