- Date
- 8/13/2024
- Report number
- 00354939-AP-305254
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to properly plan care
- Result
- Substantiated
- Findings
- Witness 1 (W1) has a history of wandering into other resident rooms including Alleged Victim's (AV's), which used to be W1's room. W1 has history of becoming upset at staff when redirected. On or about June 6, 2024, W1 was upset with staff due to staff not letting W1 go into AV's room, and attempted to hit staff due to being upset, requiring PRN Psychiatric medication to be given. On or about July 7, 2024, An altercation between W1 and AV took place when W1 entered AV room and W1 hit AV with W1's bag twice before leaving the room. On or about August 13, 2024, AV was receiving care from staff when W1 wandered into AV room and became upset. W1 swung W1's bag at staff and hit AV on the hand and finger unintentionally. The only instruction to staff in W1's service plan is to redirect W1 if W1 wanders. There is nothing in W1's care plan regarding W1's behaviors or agitation. A temporary service plan was put in place after this altercation to have staff redirect W1 from AV's room specifically. The facility failed to adjust the service plan and implement reasonable interventions to address W1 continued wandering into resident rooms, and aggressive behaviors, to protect the safety of other residents, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
- Sanction
- RCFCP25-00327 $500.00 fine assessed