Print Violation: 00290484-AP-244490

Provider Information

The Arbor at Avamere Court

450 CLAGGETT COURT N
Keizer, OR 97303

Date: 10/9/2023
Report number: 00290484-AP-244490
Type: Abuse: Neglect
Level: 3 - Moderate harm or potential for serious 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: The facility failed to implement interventions and provide appropriate supervision related to the Alleged Victim’s (AV) known history of falls. On or about October 9, 2023, AV fell and sustained a hip fracture. Based on facility documentation and interviews, AV had previous falls on April 17,2023, July 1, 2023, July 28, 2023, and August 8, 2023; four of these five falls occurred in AV's bathroom. The facility's failure to implement fall preventions/interventions regarding AV's care needs with toileting and mobility assistance to and from the bathroom, caused AV to experience multiple falls, causing unreasonable discomfort, which is a violation of resident rights, is considered neglect of care and constitutes abuse.
Sanction: RCFCP23-01506 $1125.00 fine assessed