Violation Details: 00082241-AP-061151

Date
5/2/2020
Report number
00082241-AP-061151
Type
Abuse: Neglect
Level
4 - Serious harm, death, imminent danger or chronic regulatory noncompliance
Allegation
Failed to properly plan care
Result
Substantiated
Findings
The facility failed to appropriately care plan for the Alleged Victim regarding his/her risk of falls. On February 21, 2020, the facility received a doctors order for a wheel chair alarm to assist in preventing falls, which the facility failed to enact. In the following three months, the Alleged Victim had multiple falls from standing up from his/her wheelchair. On or about May 2, 2020, the Alleged Victim was found on the floor from a fall after standing up from his/her wheelchair, was transported to the hospital for treatment and was diagnosed with a head laceration, extensive facial fractures, a brain bleed and passed several days later. The facility's failure is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction
RCFCP20-01017 $2500.00 fine assessed