Violation Details: 00028011-AP-019775

Date
4/18/2019
Report number
00028011-AP-019775
Type
Abuse: Neglect
Level
4 - Serious harm, death, imminent danger or chronic regulatory noncompliance
Allegation
Failed to intervene when resident's condition changed
Result
Substantiated
Findings
Alleged Victim (AV) resides on the second floor of the facility. AV is dependent on using a wheelchair for ambulation. A few weeks prior to the incident AV showed increased signs of confusion. On the day of the incident AV was exhibiting facial drooping and increased confusion by setting out hand soap and room deodorizer on the serving tray to be taken to the kitchen. AV left his/her room and fell down the stairs causing a hip fracture that needed surgical repair. The facility failed to address AV's change of condition which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction
ALFCP20-00151 $2500.00 fine assessed