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F0658
E

Failure to Label Enteral Feeding and IV Lines According to Professional Standards

Pleasant Hill, California Survey Completed on 08-15-2025

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

The facility failed to ensure that services provided met professional standards of quality for three residents who required specialized nutritional and intravenous care. For one resident receiving enteral feeding due to malnutrition and dysphagia, the fiber source nutrition bag and tubing were not labeled with the date and time as required. The nursing supervisor confirmed that labeling was necessary for safety and infection control, and that the omission placed the resident at risk for complications. Facility policy required that enteral feeding bags and tubing be labeled with the date and time when prepared and administered. Two other residents receiving intravenous therapy also had deficiencies in labeling. One resident with dysphagia had an IV line secured with Tegaderm, but neither the dressing nor the IV tubing was labeled, making it unclear when the IV line was placed or changed. The Director of Nursing acknowledged that this failure could lead to infection and complications. Another resident with metabolic encephalopathy had a peripheral IV line and tubing that were also not labeled. The nursing supervisor stated that labeling with date and time was required to prevent infection. Facility policy specified that all IV tubing must be labeled with date, time, and initials.

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