Violation Details: 00387564-AP-338048

Date
3/7/2025
Report number
00387564-AP-338048
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide peri care
Result
Substantiated
Findings
The Alleged Victim (AV) requires services from the facility which include brief changes. AV is know to have skin breakdown in the peri area and has an as needed barrier cream to be applied during brief changes. On or about March 7, 2025, AV suffered a fall where he/she hit his/her head. AV was transported to the hospital, where hospital staff noted that AV had a very heavily soiled brief and an open area of skin breakdown, indicating AV had been in soiled briefs for an extended period of time. Although staff maintain that AV was changed a few hours prior, There is no documentation that AV refused care, was changed, nor is there documentation that AV's barrier cream was applied. The facility's failure to provide incontinence care to AV is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction
RCFCP25-00502 $188.00 fine assessed