Failure to Ensure Proper Respiratory Equipment Care and Labeling
Penalty
Summary
The facility failed to provide safe and appropriate respiratory care for multiple residents by not ensuring proper storage, cleaning, and labeling of respiratory equipment. Observations revealed that several residents had nebulizer masks or medication chambers with visible fluid left in them after use, and the equipment was not properly cleaned, separated, or stored as per facility policy. In one case, a resident's nebulizer mask was left on the dresser with fluid in the medication cup, and there was no care plan or intervention documented for nebulizer use. Other residents were found with nebulizer equipment containing fluid days after their last treatment, and staff confirmed that the equipment should have been cleaned and stored appropriately but was not. Additionally, a resident receiving oxygen therapy had tubing that was not labeled or dated as required by facility policy, and staff acknowledged that labeling should have occurred upon admission but did not. The residents involved had various diagnoses including COPD, asthma, respiratory failure, heart failure, and mental health conditions. At the time of the deficiencies, some residents were no longer receiving nebulizer treatments, yet equipment with residual medication was still present at the bedside. Staff interviews confirmed that the observed practices did not align with facility policies, which require cleaning, drying, and proper storage of nebulizer equipment, as well as labeling and dating of oxygen tubing. The lack of adherence to these procedures was directly observed and verified by nursing management.