Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

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Print Violation: 00084673-AP-063205

Provider Information


Oak Park Senior Living

1400 NE ROCKY RIDGE DRIVE
Roseburg, OR 97470

Provider ID
70M225
Administrator
Tamera Schmall
Phone
(541) 464-5656
Email
tschmall@cogirusa.com

Violation Details


Date
5/18/2020
Report number
00084673-AP-063205
Type
Abuse: Neglect
Level
4 - Serious harm, death, imminent danger or chronic regulatory noncompliance
Allegation
Failed to properly plan care
Result
Substantiated
Findings
Alleged Victim (AV) experienced a change in condition April 25, 2020. AV was described as having increased confusion, uncontrolled bowels, profanity, anger and his/her apartment was in a disarray. AV was sent out to the emergency room on April 28, 2020 and discharged with instructions to follow up with his/her physician. Appointments were made, including a telehealth appointment however none of the appointments were completed. On or about May 5, 2020, progress notes indicate AV was getting weaker and may require a wheelchair for ambulation and had additional hazards in his/her room. On or about May 11, 2020, staff note that AV had bruising on his/her face, increased behaviors, going into other residents rooms, and concerns with falls. AV experienced falls on or about May 13th, May 8th, May 7th, May 13th, May 14th and May 16, 2020. The facility sent faxes to AV's physicians but noted all falls were non-injury. AV's physician recommend a higher level of care in April 2020 and May 8, 2020. On or about May 18, 2020, AV was sent to the emergency room unresponsive, diagnosed with a brain bleed and passed away. The facility failed to care plan according to AV's change of condition of increased falls and the identified need of a higher level of care, which is a violation of resident rights, is neglect of care and constitutes abuse.
Sanction
ALFCP20-00629 $2500.00 fine assessed