Failure to Provide Safe and Appropriate Respiratory Care
Penalty
Summary
The facility failed to provide safe and appropriate respiratory care for two residents by not adhering to physician orders and proper documentation. For one resident with chronic obstructive pulmonary disease who was dependent on staff for daily care, physician orders required weekly cleaning of the oxygen concentrator and filter, and changing of the oxygen tubing and humidifier every seven days. However, observations revealed that the oxygen concentrator and filter had a thick removable substance, and the tubing and humidifier were dated from a previous week, indicating they had not been cleaned or changed as documented in the treatment administration record. The Director of Nursing confirmed that the equipment was not maintained as required, despite documentation stating otherwise. For another resident with pleural effusion and atrial fibrillation, nursing notes indicated the resident developed respiratory symptoms and was subsequently observed receiving oxygen at 2 liters per minute via nasal cannula. Despite ongoing administration of oxygen, there was no physician order for this therapy in the resident's clinical record. The Nursing Home Administrator confirmed that oxygen was being administered without a physician's order, contrary to facility policy and regulatory requirements.