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F0695
D

Failure to Administer Oxygen at Ordered Flow Rate

Titusville, Pennsylvania Survey Completed on 06-06-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to provide oxygen therapy according to the physician's orders for one resident. Facility policy required staff to review the physician's order and administer oxygen at the prescribed flow rate. The resident, who had diagnoses including chronic obstructive pulmonary disease, diabetes, and acute respiratory failure, had a physician's order for oxygen at 6 liters per minute via nasal cannula. However, multiple observations on the same day showed the resident receiving oxygen at 8.5 liters per minute. The Director of Nursing confirmed that the oxygen was not set according to the physician's order.

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