Failure to Update Care Plan for Oxygen Use
Penalty
Summary
The facility failed to review and revise the care plan for a resident after a comprehensive assessment, specifically neglecting to update the care plan to reflect the resident's use of oxygen. The resident, a 74-year-old male with diagnoses including unspecified dementia, respiratory failure with hypoxia, and general anxiety disorder, had a physician's order for oxygen to be used as needed. Despite this order, the care plan dated several months after the oxygen order did not include any mention of oxygen use. Observations confirmed that the resident was using an oxygen concentrator, and interviews with staff revealed that the omission was due to a misunderstanding that only full-time oxygen use required care planning. Both the ADON and DON acknowledged that the resident's as-needed oxygen use was not included in the care plan, contrary to facility policy, which requires care plans to be revised as residents' conditions change.