Violation Details: 00067308-AP-048803

Records Request Print
Date
1/17/2020
Report number
00067308-AP-048803
Type
Licensing Violation
Level
3 - Moderate harm or potential for serious harm
Allegation
Failed to provide safe environment
Result
Substantiated
Rule(s) Violated
External site: 411-054-0025(1)(a) and (b)
External site: 411-054-0028(2)
Findings
On or about January 17, 2020, in the middle of the night AV fell in his/her room and pressed his/her call button for assistance. Alleged Perpetrator 2 (AP2) responded to AV's call request and assisted AV back to bed. At approxemetly 4:00 pm the next day AV told another facility staff he/she fell and was experiencing pain. AV was transported to the hospital and diagnosed with a fractured left acetabulum. AP2 failed to assess AV for injury after the fall and failed to notify other staff of the falls causing a delay of care and extended unreasonable discomfort. AP2's actions are considered neglect of care and constitutes abuse. The facility failed to provide a safe environment which is a violation of Oregon Administrative Rules.