Print Violation: 00377511-AP-327945

Provider Information

River Terrace Memory Care

950 SOUTH END RD
Oregon City, OR 97045

Date: 1/13/2025
Report number: 00377511-AP-327945
Type: Abuse: Neglect
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to provide a safe medication administration system
Result: Substantiated
Rule(s) Violated: 411-054-0025(1)(a) and (b)
411-054-0027(1)(g) and (s)
411-054-0028(2)
411-054-0055(1)(a)
Findings: The Alleged Victim (AV) relies on the facility for care, which includes medication management. On or about January 13, 2025, AV was given another residents medication, resulting in AV experiencing diarrhea. According to an investigation, there was not a multistep authentication process to verify medications match the physician order prior approving them in the MAR and administering. The facility failed to provide a safe medication system, which is a violation of resident rights, is considered neglect of care and constitutes abuse. The Allegation that AP2 neglected AV was unsubstantiated.
Sanction: RCFCP25-01381 $188.00 fine assessed