Violation Details: 00310450-AP-263167

Date
1/31/2024
Report number
00310450-AP-263167
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to follow care plan
Result
Substantiated
Findings
The Alleged Victim (AV) is care planned to have his/her brief changed every two hours. On or about January 31, 2024, it was discovered that AV hadn't been changed and his/her sheets and bedding were soaked through to the mattress. It was discovered that night shift staff were not checking or changing AV every two hours as stated in the care plan. Staff didn't want to wake AV to change him/her. Staff were told they needed to wake AV to change him/her if necessary. The facility's failure to follow the care plan placed AV at risk for harm and placed AV in unreasonable discomfort. The facility's failure is a violation of resident rights, are considered neglect of care and constitute abuse.
Sanction
ALFCP24-00172 $188.00 fine assessed