Failure to Provide Safe and Appropriate Respiratory Care
Penalty
Summary
The facility failed to provide respiratory care consistent with professional standards of practice for four residents requiring oxygen therapy or nebulizer treatments. For one resident with COPD, the oxygen was not set at the physician-ordered rate of 2 liters via nasal cannula as needed for shortness of breath or oxygen saturation below 93%. The resident stated reliance on staff for oxygen management, and the LPN was unaware the oxygen setting was incorrect, attributing it to possible accidental adjustment during care. The DON confirmed there was no specific policy for oxygen administration. Another resident with Parkinson's disease and congestive heart failure was observed with an oxygen concentrator set at 4 liters per minute, contrary to the physician's order for continuous oxygen at 2 liters via nasal cannula. The oxygen concentrator was also placed out of the resident's reach. The LPN acknowledged the discrepancy and stated the need to follow physician orders. Additionally, two residents receiving nebulizer treatments had their nebulizer masks improperly stored. One resident's nebulizer mask was left unbagged and unlabeled on the bedside table, and another's was left on a blanket on a chair after use. Facility policy required nebulizer equipment to be stored hygienically, bagged, and labeled when not in use. The DON confirmed the expectation for proper storage of respiratory equipment, and facility policy supported this requirement.