Failure to Provide Required Respiratory Care
Penalty
Summary
Amoroso Healthcare and Rehabilitation Woodridge was found to be non-compliant with the requirement for providing respiratory care consistent with professional standards of practice. The deficiency involved a resident who was admitted to the facility with a need for BiPAP therapy, as indicated in the hospital referral paperwork. The resident, who had chronic kidney disease and diabetes, was admitted to the facility in the evening with a documented need for BiPAP at night and as needed during the day. However, upon admission, the facility did not have a spare BiPAP machine available, and the oxygen supply company could not deliver one until the following day. The situation escalated when the resident requested to be sent back to the hospital if the BiPAP could not be provided for the night, leading to the resident's transfer back to the hospital. During an interview, the Director of Nursing and the Nursing Home Administrator acknowledged receiving the referral that mentioned the need for BiPAP but noted that the hospital used Careport for communication, which did not involve verbal communication with the facility. The responsibility for reviewing and approving referrals was shared among the DON, NHA, and Director of Social Services.
Plan Of Correction
1. Resident #5 no longer resides in the facility. 2. An audit will be completed by the Resident Care Navigator or designee of the last 30 days of admissions to determine if residents admitted needed a bipap received one at admission. Corrections will be made as necessary. 3. Education will be provided to the NHA, DON, and Resident Care Navigator regarding the following new process. Referrals will be reviewed by the NHA, DON, Resident Care Navigator or designee to determine if a bipap is needed and the Resident Care Navigator or designee will confirm with the hospital Case Manager the need for a bipap at admission. This information will be discussed at the clinical meeting and arrangements will be made to obtain the needed equipment prior to admission. Equipment needs and settings will be documented in the resident's medical record. 4. A new admission tracker will be kept by the Resident Care Navigator with the information needed to admit a resident with a bipap. This tracker will be reviewed weekly x four by the NHA or designee for accuracy. Results of the tracker review will be reviewed at the monthly Quality Assurance Committee meeting.