Failure to Obtain Physician Orders for CPAP Use
Penalty
Summary
The facility failed to ensure that two residents using CPAP (Continuous Positive Airway Pressure) machines had appropriate physician orders for their use. One resident reported that their family set up the CPAP machine and that the facility only assisted by providing distilled water, with no physician order present for the device. The respiratory therapy staff confirmed that they do not manage residents' personal CPAP machines and that nursing staff are responsible for obtaining physician orders, which should include the prescribed settings. However, review of the resident's records showed no physician order for the CPAP machine. Another resident's spouse stated that they brought the CPAP machine to the facility and instructed a CNA on its use, but observed that the machine was not used as intended and that staff did not assist with its application at night. The resident's records, including hospital discharge instructions and nurse practitioner notes, indicated CPAP dependence and nightly use, but there was no physician order for the CPAP during the resident's stay. The facility's respiratory supplies policy did not address the need for a physician order for respiratory treatments.