Violation Details: 00444439-AP-396439

Records Request Print
Date
11/27/2025
Report number
00444439-AP-396439
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), 411-054-0027(1)(g) and (s), 411-054-0028(2), 411-054-0055(1)(f)
Findings
The Alleged Victim (AV) relies on the facility to administer his/her medications. According to an investigation, on or about November 27, 2025, the Alleged Perpetrator 2 (AP2) marked the narcotics log that AV's "as needed" pain medication was administered, but the medication was not administered to the AV, resulting in ongoing unreasonable discomfort. The pain medication was not administered to AV but was marked as "administered in the narcotics log on November 27, 29th and December 3, 2025. AP2 admitted to stealing the narcotics medication. AP2's actions are considered neglect and constitutes abuse. The facility failed to protect the AV from neglect and ensure a safe medication administration system, which violates Oregon Administrative Rules, is considered neglect and constitutes abuse.
Sanction
RCFCP26-00325 $188.00 fine assessed