Print Violation: 00360453-AP-316106

Provider Information

Klamath Falls Senior Living

2130 N ELDORADO AVE
Klamath Falls, OR 97601

Date: 9/20/2024
Report number: 00360453-AP-316106
Type: Abuse: Neglect
Level: 3 - Moderate harm or potential for serious harm
Allegation: Failed to provide service
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: 411-054-0036(2)(g)
Findings: The Alleged Victim (AV) is care planned for two-person transfers and on-person assist for ambulation. AV is known to not like to rely on facility staff to help with transfers or ambulation and forgetting to use his/her call button. According to the investigation, AV had approximately six falls between June 28, 2024, and October 17, 2024, while attempting to self-transfer, resulting in some injuries, including a pelvic rami fracture, a concussion and multiple skin injuries. The facility failed to provide appropriate services according to resident needs, relating to care planning and lack of appropriate interventions, to mitigate falls and self-transferring, which is a violation of resident rights, is neglect of care which constitutes abuse.
Sanction: ALFCP25-00047 $1500.00 fine assessed