Failure to Ensure Physician Orders and Care Planning for Respiratory Therapy
Penalty
Summary
The facility failed to provide safe and appropriate respiratory care for a resident with multiple respiratory diagnoses, including asthma, COPD, and obstructive sleep apnea. The resident was observed to use both an oxygen concentrator and a CPAP device, and confirmed using the CPAP every night and oxygen as needed. However, a review of the resident's medical record revealed there were no active physician's orders for CPAP therapy or for oxygen use while at the facility, despite evidence of regular use. The care plan only addressed PRN oxygen use and did not mention CPAP therapy or its maintenance. Interviews with nursing staff and the DON confirmed that the resident should have had signed physician's orders and care planning for CPAP therapy, and that staff should be monitoring the application of respiratory devices. Facility policy also requires verification of physician's orders and review of the care plan prior to oxygen administration. The lack of appropriate orders and care planning for the resident's respiratory therapies constituted a failure to provide care consistent with professional standards and the resident's comprehensive care plan.