Print Violation: 00068233-AP-049460

Provider Information

Bonaventure of Salem Memory Care

3411 BOONE RD SE
Salem, OR 97317

Date: 1/26/2020
Report number: 00068233-AP-049460
Type: Abuse: Neglect
Level: 4 - Serious harm, death, imminent danger or chronic regulatory noncompliance
Allegation: Failed to assure physician services
Result: Substantiated
Rule(s) Violated: External site: 411-054-0025(1)(a) and (b)
External site: 411-054-0027(1)(f) and (r)
External site: 411-054-0028(2)
External site: 411-054-0036(2)(g)
External site: 411-054-0040(1)(b) and (c), (2)
External site: 411-054-0045(1)(a) and (f)(A)
Findings: The facility, Alleged Perpetrator 2 (AP2) and Alleged Perpetrator 3 (AP3) failed to have an adequate system in place to respond to AV's change in condition and seek emergency services when his/her condition worsened. According to documentation, AP2 and AP3 were contacted multiple times by staff with concerns of AV's change of condition, and requesting to seek emergency medical services. AV was not assessed from approximately 11:45 pm until 9am the following morning, when AV was found deceased. The failure is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP20-00561 $2500.00 fine assessed