Provider Details

Aging and People with Disabilities

Safety, Oversight and Quality

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Print Violation: 00239139-AP-196129

Provider Information


Magnolia Gardens Memory Care

1355 DAUGHERTY AVE
Cottage Grove, OR 97424

Provider ID
50R314
Administrator
Christina Sexton
Phone
(541) 942-8966
Email
mc.director@magnoliagardenssl.com

Violation Details


Date
1/3/2023
Report number
00239139-AP-196129
Type
Abuse: Neglect
Level
2 - Minor harm or potential for moderate harm
Allegation
Failed to provide service
Result
Substantiated
Findings
INITIAL: The facility failed to provide appropriate care and services according to Alleged Victim (AV) needs and failed to complete a change of condition. AV was admitted into the facility on or around December 05, 2022, with a stage two pressure wound. On or around December 31, 2022, AV was admitted into the hospital with a diagnosis of sepsis with encephalopathy, acute osteomyelitis, and malodorous sacral ulcer stage four. Alleged Perpetrator #2 (AP2) failed to follow medical treatment orders, by packing AV wound with barrier cream, and did not administer PRN pain medication to AV when AV was noted to be in pain during wound care. AP2’s actions are a violation of resident rights, are considered neglect of care and constitute abuse. Alleged Perpetrator #3 (AP3) failed to assess, complete a change of condition, and ensure AV was receiving wound care services, when AV’s wound was noted to be malodorous and worsening. AP3’s actions are a violation of resident rights, are considered neglect of care and constitute abuse. The facility failure to ensure adequate supervision and oversight of AV’s care, resulted in AV experiencing increased pain and unreasonable discomfort, which is a violation of resident rights, is considered neglect of care and constitutes abuse. AMENDED: The facility failed to provide appropriate care and services according to Alleged Victim (AV) needs. AV was admitted into the facility on or around December 05, 2022, with a stage two pressure wound. Alleged Perpetrator #2 (AP2) failed to administer PRN pain medication to AV when AV was noted to be in pain during wound care. AP2’s actions are a violation of resident rights, are considered neglect of care and constitute abuse. The facility failure to ensure adequate supervision and oversight of AV’s care, resulted in AV experiencing increased pain and unreasonable discomfort, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction
RCFCP23-00542 $250.00 fine assessed