Print Violation: 00373256-AP-323821

Provider Information

St Andrews Memory Care Community

7617 SE MAIN ST
Portland, OR 97215

Date: 12/22/2024
Report number: 00373256-AP-323821
Type: Abuse: Neglect
Level: 3 - Moderate harm or potential for serious harm
Allegation: Failed to follow care plan
Result: Substantiated
Rule(s) Violated: External site: 411-054-0025(1)(a) and (b)
External site: 411-054-0027(1)(g)
External site: 411-054-0036(2)(g)
Findings: Alleged Victim (AV) relies on the facility for his/her care and has a history of skin issues. AV is care planned to wear geri-sleeves during the day and at night they need removed, washed and skin integrity observed. According to an investigation, on or about December 22, 2024, AV’s left thumb was swollen, and blood was noted to be on AV’s geri-sleeve. When staff attempted to remove the geri-sleeve, AV showed signs of pain and cried out. The geri-sleeve was cut off and a deep skin wound was observed. AV was sent to the hospital where AV was diagnosed with a Stage IV wound, likely caused by staff not removing AV’s geri-sleeve. The facility failed to follow the care plan which is a violation of resident’s rights is neglect of care and constitutes abuse.
Sanction: RCFCP25-00043 $1125.00 fine assessed