Print Violation: 00169946-AP-134844

Provider Information

Wildflower Lodge Assisted Living Community

508 16TH STREET
La Grande, OR 97850

Date: 11/12/2021
Report number: 00169946-AP-134844
Type: Abuse: Neglect
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to properly plan care
Result: Substantiated
Rule(s) Violated: External site: 411-054-0027(1)(f) and (r)
External site: 411-054-0028(2)
External site: 411-054-0036(2)(g)
Findings: Alleged Victim (AV) is care planned to receive frequent checks during the nighttime hours due to occasional incontinence and to receive brief change assistance. On or about November 3, 2021, it was discovered AV had an open sore on AV’s right buttock measuring 1 cm in length and 2 cm in width. On or about November 18, 2021, it was noted that AV’s bed was saturated in urine and AV had not been out of bed in a week, on November 10, 2021, AV was discovered to be in urine saturated and feces-stained sheets. At this time AV’s pressure ulcer was examined and it was noted there was deep tissue injury present as evidence by a purple appearance. AV often denied needed change and would usually refuse to allow staff to change him/her. The facility failed to care plan around AV’s frequent refusal on incontinence change, which is a violation of resident rights, is neglect of care and constitutes abuse.
Sanction: ALFCP22-00740 $500.00 fine assessed