Print Violation: 00218238-AP-177219

Provider Information

Jefferson Lodge Memory Care Community

664 SE JEFFERSON ST
Dallas, OR 97338

Date: 8/26/2022
Report number: 00218238-AP-177219
Type: Abuse: Neglect
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to follow care plan
Result: Substantiated
Rule(s) Violated: External site: 411-054-0025(1)(a) and (b)
External site: 411-054-0027(1)(f) and (r)
External site: 411-054-0028(2)
External site: 411-054-0036(2)(g)
Findings: Witness 1 (W1) has history of combative behaviors and altercations with other residents. W1 is care planed and has interventions in place when agitated. On or about August 26, 2022, W1 became agitated and tried to enter Alleged Victim (AV) room by pushing through the door. W1 hit AV on h/h left cheek and arm, resulting in redness. The facility failed to follow the care plan and interventions to address W1s behaviors, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP22-01794 $500.00 fine assessed