- Date
- 5/26/2020
- Report number
- 00085509-AP-063837
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to provide a safe medication administration system
- Result
- Substantiated
- Findings
- Alleged Victim (AV) was care planned for facility assistance with medication administration. AV was prescribed an as needed medication for pain. The facility states they need to try three non-medication interventions prior to giving AV his/her pain medication. The medication orders as written on the medication administration record do not include non-medication interventions nor does AV's care plan provide staff instruction on providing non-medication intervention. AV service plan stated that AV had a wound or pressure ulcer that required weekly monitoring. The service plan stating where the wound was located, how staff should care for the wound, and what staff should report to medical staff was left blank. The facility kept minimal documentation about how to meet AV's significant care needs, including information about AV's pain management and care for a wound, putting AV at risk for serious harm. The facility's failure is a violation of resident rights, is neglect of care and constitutes abuse.
- Sanction
- RCFCP20-01187 $500.00 fine assessed