- Date
- 8/22/2025
- Report number
- 00424347-AP-375877
- Type
- Abuse: Neglect
- Level
- 2 - Minor harm or potential for moderate harm
- Allegation
- Failed to provide safe environment
- Result
- Substantiated
- Findings
- Alleged Victim (AV) relies on the facility for his/her care needs. On or about August 15, 2025, AV was transported to the ER due to AV expressing discomfort and pain all night, pleading for help, and becoming combative. AV returned to the facility the same day with no new orders, instructions, or medication. On or about August 22, 2025, AV was completely non-weight bearing, requiring three staff assist for transfers, and was transported to the ER for suspected constipation. On or about August 28, 2025, AV was diagnosed with a fracture back attributed to a previous fall and returned to the facility. Respondent failed to provide a safe environment, to ensure the safety of AV. This constitutes abuse by neglect, as outlined in OAR 411-020-0002(1)(b)(A)(i).
- Sanction
- RCFCP26-00316 $500.00 fine assessed