Failure to Implement Tube Feeding Orders Upon Readmission
Penalty
Summary
The facility failed to implement tube feeding orders for a resident upon readmission from the hospital. The resident, who had diagnoses including COPD, major depressive disorder, anxiety disorder, and mild protein-calorie malnutrition, was readmitted with a hospital order for Nutren 2.0 tube feeding at a specified rate. However, there was no corresponding physician order for tube feeding entered into the resident's medical record upon return, and the Medication Administration Record did not document any tube feeding administration during the relevant period. The care plan identified the resident as being at moderate nutritional risk and included interventions to provide enteral feedings as ordered. Despite this, the Director of Nursing confirmed that tube feeding was not provided from the time of readmission because the facility did not have the prescribed formula available. Facility policy indicated that staff could use products from a basic formulary until specialized products could be delivered, but this was not done, resulting in the resident not receiving the ordered nutritional support.