Print Violation: 00236732-AP-194061

Provider Information

Cedar Crest Alzheimer Special Care Center

18325 SW PACIFIC HWY
Tualatin, OR 97062

Date: 12/8/2022
Report number: 00236732-AP-194061
Type: Abuse: Neglect
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)(f) and (r)
External site: 411-054-0028(2)
External site: 411-054-0055(1)(a) and f)
Findings: The facility failed to provide a safe medication administration system to ensure the AV’s medication orders were administered as prescribed. On or about December 08, 2022 – December 13, 2022, AV was double dosed on an antipsychotic medication, causing AV to have increased somnolence. The facility’s failure is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP23-00546 $338.00 fine assessed