Failure to Administer Oxygen Therapy as Ordered
Penalty
No penalty information released
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 respiratory services as ordered by the physician for two residents. One resident with diagnoses including respiratory failure and morbid obesity was observed on two occasions with their oxygen concentrator set at 3.5 liters per minute (lpm), despite a physician order for oxygen via nasal cannula at 1 to 2 lpm to maintain oxygen saturation at or above 88%. Another resident with osteolysis and malnutrition was observed with their oxygen concentrator set at 3.5 lpm, while the physician order specified 2 lpm via nasal cannula to keep oxygen saturation above 90%. The Director of Nursing confirmed that both residents' oxygen concentrators were set higher than ordered.