Print Violation: 00110837-AP-094733

Provider Information

Autumn House of Grants Pass

2268 WILLIAMS HWY
Grants Pass, OR 97527

Date: 11/5/2020
Report number: 00110837-AP-094733
Type: Licensing Violation
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to provide a safe medication administration system
Result: Substantiated
Rule(s) Violated: External site: 411-054-0025(1)(a) and (b)
External site: 411-054-0027(1)(r)
Findings: The Alleged Perpetrator 2 failed to provide a safe medication administration system to ensure the Alleged Victim's (AV) medication was administered as ordered. The failure resulted in AV receiving another resident's medication and was transferred to the hospital, placing him/her at risk of harm, which is a violation of resident rights, is considered neglect of care and constitutes abuse. The facility failed to protect AV from neglect, which is a violation of Oregon Administrative Rules.