Violation Details: 00115813-AP-089551

Date
11/20/2020
Report number
00115813-AP-089551
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) relies on the facility to administer his/her medication. On or about October 22, 2020, AV received a refill of his/her Oxycodone for 60 tables. On or about November 18, 2020, 12 tablets of AV’s Oxycodone were reported unaccounted for. The facility did not have a system to audit narcotic books prior to November 14, 2020, and the policy for checking-in narcotic medication was not being followed. Alleged Perpetrator 2 (AP2) assumed primary responsibility for medication administration, destroying medication as needed, ordering medication, and documenting in the NARC books. AP2 and the facility failed to provide a safe medication administration system, which is a violation of resident rights, is neglect of care and constitutes abuse.
Sanction
ALFCP22-00999 $500.00 fine assessed