Print Violation: 00129710-AP-101203

Provider Information

Arbor House of Grants Pass

820 GOLD COURT
Grants Pass, OR 97527

Date: 3/14/2021
Report number: 00129710-AP-101203
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: 411-054-0055(1)(a) and (f)
Findings: The Alleged Perpetrator 2 (AP2) failed to provide a safe medication administration system to administer the Alleged Victim's (AV) medication as ordered. The failure resulted in AV receiving another residents medication 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 a medication error, which is a violation of Oregon Administrative Rules.