Violation Details: 00376076-AP-326464

Date
1/5/2025
Report number
00376076-AP-326464
Type
Abuse: Neglect
Level
3 - Moderate harm or potential for serious harm
Allegation
Failed to properly plan care
Result
Substantiated
Findings
The Alleged Victim (AV) was a known fall risk before arriving at the facility and after AV arrived at the facility. AV is care planned to cue AV to use his/her call light to transfer and to use his/her walker or wheelchair for mobility. AV suffered falls on November 11, 2024 and November 23,2024, noting that AV's footwear was a contributing factor to AV's falls. The facility failed to update AV's service plan with interventions regarding AV's footwear as a contributing factor to his/her falls. On or about January 5, 2025, AV suffered a fall while ambulating alone. AV was wearing only socks at the time of this fall. AV complained of pain and was transferred to the hospital where is was determined that AV suffered a broken pelvis. The facility's failure to properly care plan is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction
RCFCP25-00487 $1500.00 fine assessed