Violation Details: 00318598-AP-270527

Date
3/12/2024
Report number
00318598-AP-270527
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to follow care plan
Result
Substantiated
Findings
Alleged Victim (AV) is a high fall risk and has a history of falls. On or about February 22, 2024, AV fell, suffering a bleeding scalp laceration and was sent to the hospital. On February 26, 2024, the facility amended AV's Service Plan to require staff to place a pad alarm "motion mat" under AV while in h/h chair or in bed. AV has a motion mat is to follow AV, i.e. bed to chair, chair to bed. On or about March 12, 2024, AV fell after getting up from h/h chair. AV's pad alarm was not in place at the time of AV fall. The facility failed to follow the care plan, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction
RCFCP24-01027 $375.00 fine assessed