Failure to Develop Care Plan for Resident's Respiratory Equipment
Penalty
Summary
The facility failed to develop a care plan addressing the use of respiratory durable medical equipment, specifically a cough assist device and a suctioning device, for a resident diagnosed with amyotrophic lateral sclerosis (ALS), dysphagia, rheumatoid arthritis, depression, and anxiety. The resident, who was admitted from home and receiving hospice services, was cognitively intact but unable to speak, requiring substantial to maximal assistance with daily activities and was dependent on staff for transfers and mobility. The resident used a ventilator at night and had an airway clearance device at bedside, but the care plan did not include any problems, goals, or approaches related to these respiratory devices. Interviews with facility staff revealed that the resident had been using the respiratory equipment at home and continued to use them independently in the facility. Staff had not been in-serviced on the use of the cough assist device or the ventilator, and only one staff member was familiar with the ventilator. The care plan lacked entries for the respiratory devices, and although the hospice care plan indicated hospice was responsible for medical supplies, the facility did not include the devices in the resident's care plan as required by facility policy.