Violation Details: 00373992-AP-324401

Records Request Print
Date
12/23/2024
Report number
00373992-AP-324401
Type
Abuse: Neglect
Level
3 - Moderate harm or potential for serious harm
Allegation
Failed to provide a safe medication administration system
Result
Substantiated
Rule(s) Violated
External site: 411-054-0025(1)(a) and (b)
External site: 411-054-0027(1)(g)
External site: 411-054-0028(2)
External site: 411-054-0055(1)(a) and (f)
Findings
The Alleged Victim (AV) receives his/her medication from facility staff. On or about December 17, 2024, the facility had not received the refill of AV's medication. Staff faxed the provider for the medication refill, however, they did not receive a response nor did they receive AV's medication. Additional requests were sent to the provider without response on December 20 and December 22, 2024. On or about December 23, 2024, AV suffered from a seizure due to not receiving his/her medication as ordered. From December 19, 2024 until December 23, 2024, AV missed 9 doses of his/her scheduled medication. Prior to this incident, the facility did not have safe guards in place to ensure timely availability of medication, including ensuring that staff understand to notify the Nurse or the Administrator of medications not being available. The facility's failure to ensure a safe medication administration system is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction
RCFCP25-00275 $1500.00 fine assessed