Date: 4/17/2013
Report Number: OR0000824300
Allegation: Failed to provide appropriate skin care
Type: Licensing Violation
Level: 2 - Minor harm or potential for moderate harm
Description: Evidence and interviews indicated facility failure to follow pressure ulcer care planned interventions and/or physician orders for treatment of pressure ulcers for Resident #2 and Resident #5. This failure placed residents' at risk of pressure ulcers worsening. Relevant portions of the complaint report investigation are attached.
Rule(s) Violated: 411-086-0060(2)(h)
411-086-0120(1)(b)
411-086-0140(1)(a)(A)
Result: Substantiated
Findings: The facility failed to provide the necessary care and services to prevent skin breakdown.