Aging and People with Disabilities
Safety, Oversight and Quality
Print Violation: 00274630-AP-229257
Provider Information
Wiley Creek Senior Living
5050 MOUNTAIN FIR STREET
Sweet Home, OR 97386
- Provider ID
- 70M103
- Administrator
- Trina Schneider
- Phone
- (458) 223-7111
- trina.schneider@wileycreeksl.com
Violation Details
- Date
- 6/9/2023
- Report number
- 00274630-AP-229257
- Type
- Abuse: Neglect
- Level
- 4 - Serious harm, death, imminent danger or chronic regulatory noncompliance
- 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)(g) and (s)
External site: 411-054-0028(2)
External site: 411-054-0055(1)(a) and (f)
- Findings
- On or about June 18, 2023, the Alleged Victim (AV) was transported to the hospital due to signs of unreasonable discomfort associated with shortness of breath. While hospitalized, AV was treated with an increased dosage of his/her prescribed diuretic medication to alleviate symptoms, as AV was found to have approximately 32 pounds of excess fluid, which was subsequently removed. AV returned to the facility on July 3, 2023, under hospice care. Based on facility documentation and interviews, AV had moved into the facility on June 10, 2023, approximately eight days prior to the hospitalization event. The Hospital After Visit Summary, specifically on page 5, directed that AV should continue taking the diuretic medication, 40 mg tablet daily. Following AV’s return, Alleged Perpetrator 3 (AP3) completed medication adjustments on AV’s Medication Administration Record (MAR); however, AV's prescribed diuretic medication was not entered. The facility utilizes a 3-Step Check stamp on documentation related to resident care to ensure that any changes to the resident’s care are accurately updated in the facility’s system. AP3’s signature appears as the third and final staff member confirming that the document had been reviewed and confirmed correct. AV continued to experience unreasonable discomfort after returning to the facility on July 3, 2023, due to AP3’s failure to ensure AV’s MAR accurately reflected all of AV's physician ordered medications as stated in AV’s Hospital After Visit Summary. On July 17, 2023, AV's showed signs of swelling. It was at this time that hospice and facility staff discovered the error on AV's MAR, after AV's July 3, 2023, hospital discharge. AV is diagnosed with a significant heart disease and not receiving his/her diuretic medication placed AV at risk of harm. AP3's actions caused AV to suffer from increased swelling and hospitalization which is considered neglect of care and constitutes abuse. The facility failed to provide a safe medication administration system for AV, which resulted in AV not receiving his/her prescribed diuretic medication and subsequent hospitalization after the June 18, 2023, hospitalization. The facility's failure is a violation of resident rights, is considered neglect of care which constitutes abuse. As the new owner of this facility, you are responsible for correcting any deficiencies which pre-date your ownership. You must correct violations which occurred under previous ownership, as directed by the Department. You will not be responsible for paying civil penalties incurred by previous owner(s). However, if you fail to correct identified deficiencies within the specified time you may be subject to aggravated civil penalties.