Violation Details: 00366707-AP-316946

Records Request Print Provider Details
Date
11/14/2024
Report number
00366707-AP-316946
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide a safe medication administration system
Result
Substantiated
Rule(s) Violated
411-054-0025(1)(a) and (b)
411-054-0027(1)(g) and (s)
411-054-0028(2)
411-054-0055(1)(f)
Findings
According to the documentation, the Alleged Perpetrator 2 (AP2) failed to provide a safe medication administration system by documenting the Alleged Victim’s (AV) pain patches were administered when there were not available. From approximately November 05, 2024, through November 09, 2024, the AV ran out of pain patches due to the facility failing to reorder them in time. On or about November 06 and 07, 2024, the AP2 documented on the medication administration record they administered the pain patches when none were available. A petition for reconsideration was received and additional information obtained resulting is a change in the determination. The allegation that the AP2’s actions resulted in neglect of care was unable to be determined. The facility failing to reorder the medication timely caused the AV to experience pain and unreasonable discomfort, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction
RCFCP24-01275 $0.00 fine assessed