Print Violation: 00143250-AP-112984

Provider Information

Monarch Gardens Memory Care

984 PARKVIEW DRIVE
Brookings, OR 97415

Date: 5/12/2021
Report number: 00143250-AP-112984
Type: Abuse: Neglect
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to obtain medical order
Result: Substantiated
Rule(s) Violated: External site: 411-054-0027(1)(a) and (f)
External site: 411-054-0028(2)(a) and (b)
External site: 411-054-0030(1)(e)(G)
Findings: The facility failed to ensure the Alleged Victim's (AV) care needs were being met due to a lack of service planning for catheter care, monitoring, or follow up for approximately twenty days, after the Alleged Perpetrator 2 placed a Foley catheter in AV without a doctor's order. AV’s condition worsened and was transferred to the hospital for treatment. The failure is a violation of resident rights, is considered neglect of care and constitutes abuse.