Failure to Provide Ostomy Care per Professional Standards
Penalty
Summary
The facility failed to provide ostomy care and services consistent with professional standards of practice for three out of four residents reviewed. For one resident with a urostomy, the clinical record lacked physician orders specifying urostomy care, the frequency of care, or the supplies needed. The care plan also did not include interventions for urostomy care, such as the specific type and size of appliance to be used. The resident reported that her daughter was providing the ostomy care using supplies brought from home, and that staff had only provided care once, which was not satisfactory to her. Another resident with an ileostomy had documentation indicating the presence of the ileostomy and that care was provided, but there were no physician orders for ileostomy care, nor was there a care plan detailing the specific type and size of appliance required. For a third resident with a colostomy, while physician orders and the care plan included general instructions for colostomy care and monitoring, they did not specify the type and size of appliance needed for proper care and maintenance. Interviews with LPNs revealed that nurses are responsible for ostomy care and typically gather supplies from the resident's room or central supply, but there was no indication that care was being provided according to individualized physician orders or care plans specifying appliance details. The Nursing Home Administrator confirmed that the facility did not provide ostomy care and services consistent with professional standards for these residents.