Print Violation: 00348865-AP-299261

Provider Information

The Springs at Lancaster Village

4138 MARKET ST NE
Salem, OR 97301

Date: 8/14/2024
Report number: 00348865-AP-299261
Type: Licensing Violation
Level: 3 - Moderate harm or potential for serious 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: 411-054-0028(2)- 411-054-0055(1)(f)
44-054-0027(1)(g) and (s)
Findings: According to the documentation, the Alleged Perpetrator 2 (AP2) failed to provide a safe medication administration system to the Alleged Victim (AV) by giving them more medication than prescribed. On or about August 2024, the AV was prescribed an nebulizer treatments and relies on the facility to administer all medications. The AV was experiencing difficulty breathing so the facility made the decision to send them to the ER. The AV was diagnosed with Pneumonia. The RCC received a note from the AP2 asking to re-order nebulizer treatment as they were almost out of their medication. After an investigation of why the facility was almost out of nebulizer treatment, AP2 admitted to administering the medication when they felt like the AV needed it. The failure to provide a safe medication administration system caused the AV to need emergent medical treatment at the hospital, which is a violation of resident rights, is considered neglect of care and constitutes abuse. The facility failed to provide a safe medication administration system with is a violation of Oregon Administrative Rules.