Failure to Follow Physician's Order for Oxygen Administration
Penalty
No penalty information released
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
The facility failed to follow the physician's order for administering oxygen to a resident with diagnoses including heart failure, vascular dementia, and iron deficiency. Multiple observations over several days showed that the resident's oxygen flow rate was set above the ordered 2 liters per minute (lpm), with recorded settings at 2.5 lpm, 2.75 lpm, and 3 lpm. A registered nurse confirmed the discrepancy and indicated she would check the physician's order. Review of the facility's policy and procedure for oxygen therapy specified that oxygen should be administered as ordered by the physician, which was not followed in this case.