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F0726
D

CNA Operated G-Tube Feed Pump Outside Scope of Practice

Glendora, California Survey Completed on 05-22-2025

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

Certified nursing assistant (CNA) 3 failed to work within their scope of practice by turning off a gastrostomy tube (G-tube) feed pump for a resident who had been admitted with quadriplegia and required enteral feeding via G-tube. The resident's medical records indicated intact cognition and a physician's order for continuous enteral feeding at a specified rate using a pump. During an observation, CNA 3 was seen turning off the G-tube feed pump and admitted to doing so, despite acknowledging that this task was supposed to be performed by a nurse. Interviews with licensed vocational nurses (LVN 3 and LVN 4) and the Director of Nursing (DON) confirmed that CNAs were not permitted to stop G-tube feeds or operate the pump, as it was outside their scope of practice and could lead to complications such as pump malfunction or G-tube dislodgement. The facility's failure to ensure that CNA 3 worked within their legal and ethical boundaries placed the resident at risk for adverse outcomes related to improper handling of the G-tube and feeding equipment.

See complete original report
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