Violation Details: 00256085-AP-211591

Date
4/5/2023
Report number
00256085-AP-211591
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to properly plan care
Result
Substantiated
Findings
The facility failed to provide appropriate services according to the Alleged Victim (AV)'s needs, relating to lack of care planning and instruction.  According to an investigation, the AV was care planned to have leg wrapped with a non-adherent pad due to his/her cellulitis, but the care plan also indicated that AV did not require any wound care and the Medication Administration Record (MAR) did not contain any instructions on wrapping AV’s leg.  On or about, April 4, 2023, it was discovered that Alleged Perpetrator 2 (AP2) had wrapped the Alleged Victim’s (AV) leg with gauze, without receiving wound care training, and when removed, AV experienced unreasonable discomfort. The facility’s failure is a violation of resident rights, is neglect of care and constitutes abuse.  The allegation that AP2 did not follow the care plan was investigated and determined to be Not Substantiated.
Sanction
ALFCP23-00391 $188.00 fine assessed