Print Violation: 00383710-AP-334257

Provider Information

Capital Manor Retirement Community

1955 DALLAS HWY NW
Salem, OR 97304

Date: 12/26/2024
Report number: 00383710-AP-334257
Type: Abuse: Neglect
Level: 2 - Minor harm or potential for moderate harm
Allegation: Failed to provide safe environment
Result: Substantiated
Rule(s) Violated: External site: 411-054-0025(1)(a)
External site: 411-054-0027(1)(a) and (s)
External site: 411-054-0036(2)(g)
Findings: Witness 1 (W1) has history of wondering around and entering other resident rooms, has aggressive behaviors and altercations with other residents including Alleged Victim (AV) . AV does not like when other residents enter AV's room. W1 and AV have history of resident-to-resident altercations with interventions in place, AV to participate in activities away from W1, and staff to ensure W1 is not near AV while in common areas. On December 26, 2024, W1 went into AV's room. AV pushed W1 out of AV's room resulting in AV having a skin tear 2-3 cm long on AV's upper left arm. AV was given pain medication and skin tear was bandaged. W1 complained of lower back pain, and crying after the incident and required OTC pain medications. The facility failed to provide a safe environment and properly plan care for W1's known wondering into other residents rooms, and properly care plan for other residents to not enter AV room, resulting in a resident-to-resident altercation with injury to AV and W1, which is a violation of resident’s rights, is neglect of care and constitutes abuse.
Sanction: RCFCP25-00611 $375.00 fine assessed