- Date
- 7/4/2021
- Report number
- 00148800-AP-117984
- Type
- Abuse: Neglect
- Level
- 4 - Serious harm, death, imminent danger or chronic regulatory noncompliance
- Allegation
- Failed to provide safe environment
- Result
- Substantiated
- Findings
- Alleged Victim (AV) relies on the facility for his/her care. AV was care planned for two-person transfers. AV was known to attempt unsafe self-transfers into other resident’s unoccupied beds. On or about July 7, 2021, AV fell while trying to self-transfer from his/her wheelchair to another resident’s bed. AV went to the hospital and was found to have a knee injury that required surgical intervention. The facility failed to appropriately care plan to mitigate the risk of AV self-transferring, which is a violation of resident’s rights, is neglect of care and constitutes abuse.
- Sanction
- RCFCP22-00340 $2500.00 fine assessed