Failure to Maintain and Clean Respiratory Care Equipment
Penalty
Summary
The facility failed to maintain respiratory care equipment in accordance with its own policy and physician orders for three residents. Facility policy required that humidifier bottles, oxygen tubing, and concentrator filters be changed or cleaned every two weeks and labeled with the date of change. For one resident with a discontinued nebulizer order, a nebulizer machine and mask remained in the room, with the mask found on the floor, which was confirmed by the Director of Nursing as inappropriate. Another resident receiving supplemental oxygen had a tubing bag and humidifier bottle that were not changed as required, undated oxygen tubing, and an external concentrator filter covered with a significant amount of white fluffy substance. An LPN confirmed these items were overdue for maintenance and cleaning. A third resident, also on supplemental oxygen, was observed to have an external concentrator filter covered with a copious amount of white fluffy substance, and an LPN confirmed the filter needed cleaning. All three residents had significant respiratory or cardiac diagnoses, including respiratory failure, heart failure, COPD, and emphysema. The observations and staff interviews confirmed that the facility did not follow its own protocols for respiratory equipment maintenance, labeling, and cleanliness, as required by physician orders and facility policy.