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F0609
D

Failure to Document Timely APS Notification for Abuse and Neglect Allegations

Salt Lake City, Utah Survey Completed on 06-02-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

A deficiency was identified when the facility failed to ensure that all alleged violations involving abuse and neglect were reported immediately, but not later than two hours after the allegation was made, to the administrator, State Survey Agency (SSA), and Adult Protective Services (APS). Specifically, for one resident with a history of anoxic brain damage, unspecified convulsions, diabetes mellitus, asthma, hypothyroidism, restless leg syndrome, and dysphagia, the facility's documentation of two separate incidents—an elopement and an allegation of sexual abuse—did not include a documented date that APS was notified. In the first incident, the local police found the resident wandering outside the facility and transported him to a hospital; the facility's form indicated APS was notified, but no date was recorded. In the second incident, the resident reported rectal pain and alleged rape to a nurse, but again, while the form stated APS was notified, no date was documented. The current administrator confirmed that there was no additional documentation available to verify the timing of APS notification for either event.

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