Violation Details: 00198536-AP-159473

Date
5/6/2022
Report number
00198536-AP-159473
Type
Licensing Violation
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to follow care plan
Result
Substantiated
Findings
The Alleged Perpetrator 2 (AP2) failed to follow the Alleged Victim's (AV) care plan to ensure a fall mat was in place when AV was in bed. The failure resulted in AV falling from his/her bed onto the floor causing unreasonable discomfort, which is a violation of resident rights, is considered neglect of care and constitutes abuse. The facility failed to ensure AV's care plan was followed, which is a violation of Oregon Administrative Rules.