- Date
- 9/22/2023
- Report number
- 00287241-AP-241448
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failure to provide a system that prevents theft or misuse of medication
- Result
- Substantiated
- Findings
- The Alleged Victim (AV) relies on the facility to manage their medications. According to an investigation, between approximately April 10, 2023, and September 22, 2023, an unknown Alleged Perpetrator 3 (AP3) replaced the AV's liquid narcotic pain medication with another liquid of a different color. AP3 was responsible for financial exploitation by way of theft, which constitutes abuse. Prior to this incident, during narcotic audits, staff neglected to confirm the color of the medication and to complete narcotic audits with two staff. The facility failed to ensure a safe medication system and did not keep the AV free from financial exploitation, which is a violation of resident rights, is neglect of care, and constitutes abuse. The allegation that the Alleged Perpetrator 2 (AP2) financially abused the AV was investigated and determined to be inconclusive.
- Sanction
- RCFCP25-00696 $188.00 fine assessed