- Date
- 6/17/2024
- Report number
- 00337601-AP-290202
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to answer call light in a timely manner
- Result
- Substantiated
- Findings
- Under the prior ownership: Alleged Victim's (AV)'s Care Plan indicates AV does not require scheduled safety checks, uses call light to request assistance, is a low fall risk with occasional assistance with ambulation, transfers independently. On or about May 06, 2024, AV was attempting to transfer from AV's bed to AV's power wheelchair and fell. AV used AV's Call Light pendant to notify AP1 staff of AV's fall and to request help, AP1 Staff did not respond to AV's Call Light pendant. AV used AV's Life Alert pendant to notify emergency services of AV's fall and request help. AP1 Staff did not respond to AV's Call Light pendant request until AP1 Staff saw emergency services enter AP1 and go to AV's room. AV was on the ground for 1:02:20 (1 Hour, 2 Minutes, 20 Seconds) before AP1 staff responded per the call light log. AP1 does not have a call light response policy in place, however staff report a reasonable response time to a call light is 10-15 minutes. AP1 Failed to answer call light in a timely manner to provide basic care, resulting in AV suffering unreasonable discomfort