- Date
- 9/11/2020
- Report number
- 00113006-AP-087350
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to provide service
- Result
- Substantiated
- Findings
- Alleged Victim (AV) relies on the facility for his/her care. On or about September 11, 2020, AV was prescribed continuous oxygen after AV’s oxygen level dipped to the low 70’s. There was an email correspondence between the facility and physician that included instructions for AV’s oxygen and an attached order. The order was not entered into the system before the nurse left for the weekend. The oxygen was delivered to the facility at 10 pm and there were issues that required the family to step in to ensure staff received those orders. On or about September 14, 2020, AV was prescribed narcotic medication to be administer every hour for pain. The first dose was administered at 1 pm on September 14, 2020. When the family came to the facility at 7 pm later that night, AV was exhibiting signs of discomfort and pain. Family asked staff if AV had received the second narcotic dose and was told there wasn’t a narcotic order. AV had multiple narcotic orders, some to be administer every six (6) hours and others to be administered every hour, and all were on the Medication Administration Record (MAR). The facility failed to provide service to AV, which is a violation of resident rights, is neglect of care and constitutes abuse.
- Sanction
- ALFCP21-02904 $500.00 fine assessed