Violation Details: 00127612-AP-099420

Records Request Print
Date
3/2/2021
Report number
00127612-AP-099420
Type
Licensing Violation
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide a safe medication administration system
Result
Substantiated
Rule(s) Violated
411-054-0027(1)(g) and (s)
411-054-0028(2)
411-054-0055(1)(a) and (f)
Findings
Alleged Victim (AV) relies on the facility to administer his/her medication. On or about February 27, 2021, AV’s doctor contacted the facility to request of a refill for AV’s PRN pain medication as it should have provided enough PRN pain medication to last through March 2021. Witness 2 (W2) did an audit of the Narcotic Medication Book and discovered a pattern of Alleged Perpetrator 2 (AP2) administering most of the PRN pain medication to AV in AP2’s shift. AV stated that AV rarely asked for AV’s PRN pain medication because AV didn’t like how It made him/her feel. Camera footage was reviewed and showed AP2 signing out AV’s PRN pain medication but not administering the pain medication to AV. AP2 failed to provide a safe medication administration system to AV, which is neglect of care and constitutes abuse. The facility failed to assure AV received a safe medication administration system, which is a violation of Oregon Administrative Rules.