Violation Details: 00369109-AP-319357

Date
11/26/2024
Report number
00369109-AP-319357
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide a safe medication administration system
Result
Substantiated
Findings
According to the documentation, the Alleged Perpetrator 2 (AP2) failed to follow protocols for medication pass, leading to the Alleged Victim (AV) to not receive their medications as prescribed. On or about November 26, 2024, AP2 was passing medications and failed to follow training protocols regarding AV’s medications. As a result, the AV did not receive their medications, which assist with breathing and pain management. The AP2 placed the AV at risk of harm for pain and unreasonable discomfort, which is a violation of resident rights, is considered neglect of care and constitutes abuse. The facility failed to notify the AV’s primary care provider of the missed medications which placed the AV at risk of harm, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction
RCFCP25-00511 $188.00 fine assessed