Failure to Provide Necessary Respiratory Care and Services
Penalty
Summary
A deficiency occurred when a resident with multiple diagnoses, including type 2 diabetes mellitus with neuropathy, traumatic amputation, and chronic kidney disease, was not provided with the necessary respiratory care and services as required. The resident had an order for oxygen therapy to be administered as needed via nasal cannula for respiratory distress or discomfort, with instructions to titrate to maintain oxygen saturation above 90%. Despite this, there was no order in place for changing or maintaining the resident's oxygen equipment, nor was there a care plan for respiratory therapy documented at the time the resident was observed using oxygen. The facility's policy required weekly tubing changes and regular updates to the care plan by licensed nursing staff, but these were not followed. Surveyor observations and record reviews revealed that the resident was using oxygen for significant periods each day, yet the Treatment Administration Record did not include a maintenance order for oxygen tubing, and a care plan for oxygen therapy was not present until after the survey began. The Director of Nursing confirmed that a care plan should have been developed when the resident started using oxygen consistently and acknowledged the absence of an order for weekly tubing changes as required by facility policy.