Health inspection·January 30, 2024

F 0695 Provide safe and appropriate respiratory care for a resident when needed. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, record review, and facility policy review, the facility failed to post oxygen in use signs per acceptable standards of nursing practice for Residents #10, #21, #22, #34, #47, #48 and #64. This affected seven residents (#10, #21, #22, #34, #47, #48 and #64) of 27 residents reviewed for respiratory care. The census was 67. Residents Affected - Some Findings include: 1. Record review revealed Resident #10 was admitted on [DATE]. Diagnoses included pneumonia due to methicillin resistant staphylococcus aureus (MRSA), acute respiratory failure with hypoxia, and chronic bronchitis. The physician order dated 01/27/24 indicated oxygen continuous at 2 LPM (liters per minute) via nasal cannula. 2. Record review revealed Resident #21 was admitted on [DATE]. Diagnoses included unspecified bacterial pneumonia, pulmonary hypertension, acute respiratory failure with hypoxia, chronic atrial fibrillation, congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD). The physician order dated 01/30/24 indicated oxygen at 2 LPM as needed to maintain oxygen saturation above 92 percent every shift. 3. Record review revealed Resident #22 was admitted on [DATE]. Diagnoses included pneumonia, sleep apnea and asthma. The physician order dated 01/28/24 indicated oxygen at 2 LPM via nasal cannula every shift. 4. Record review revealed Resident #34 was admitted on [DATE]. Diagnoses included pneumonia due to MRSA, acute and chronic respiratory failure with hypercapnia and hypoxia, shortness of breath, and COPD. The physician order dated 01/16/24 indicated oxygen at 3 LPM via nasal cannula continuous every shift. 5. Record review revealed Resident #47 was admitted on [DATE]. Diagnoses included atrial fibrillation, chronic bronchitis, CHF, and COPD. The physician order dated 01/27/24 indicated oxygen at 3 LPM every shift. 6. Record review revealed Resident #48 was admitted on [DATE]. Diagnoses included bronchitis, CHF, acute pulmonary edema, and acute respiratory failure with hypoxia. The physician order dated 10/23/24 indicated oxygen at 2 LPM via nasal cannula as needed. 7. Record review revealed Resident #64 was admitted on [DATE]. Diagnoses included pneumonia, acute and chronic respiratory failure, heart failure, COPD, and obstructive sleep apnea. The physician Page 1 of 2 366447 366447 01/30/2024 Concord Village Skilled Nursing & Rehabilitation 10955 Capital Parkway Concord, OH 44077

F 0695 order dated 01/19/24 indicated oxygen at 4 LPM via nasal cannula every shift. Level of Harm - Minimal harm or potential for actual harm Observation on 01/30/23 at 8:50 A.M. revealed the following: Residents Affected - Some - Resident #10 was in the room with a nasal cannula in place and the oxygen concentrator was turned on and set to 2 LPM. There was no oxygen in use safety sign posted on the entrance room door. - Resident #21 was in the room with a nasal cannula in place and the oxygen concentrator was turned on and set to 2 LPM. There was no oxygen in use safety sign posted on the entrance room door. - Resident #34 was in the room with a nasal cannula in place and the oxygen concentrator was turned on and set to 3 LPM. There was no oxygen in use safety sign posted on the entrance room door. - Resident #47 was in the room with a nasal cannula in place and the oxygen concentrator was turned on and set to 3 LPM. There was no oxygen in use safety sign posted on the entrance room door. - Resident #48 was in the room with an oxygen concentrator and nasal cannula setting on top of the concentrator which was not turned on. There was no oxygen in use safety sign posted on the entrance room door. - Resident #64 was in the room with a nasal cannula in place and the oxygen concentrator was turned on and set to 4 LPM. There was no oxygen in use safety sign posted on the entrance room door. Interview at the time of the observation with Registered Nurse #301 verified there were no oxygen in use safety signs posted on the entrance room doors for Residents #10, #21, #34, #47, #48 and #64. Observation on 01/30/24 at 8:53 A.M. revealed Resident #22 was in the room with a nasal cannula in place and the oxygen concentrator which was turned on and set to 2 LPM. There was no oxygen in use safety sign posted on the entrance room door. Interview at the time of the observation with State Tested Nursing Assistant #377 verified there was no oxygen in use safety sign posted on the entrance room door for Resident #22. Interview on 01/30/24 at 9:01 A.M. with Director of Nursing (DON) confirmed oxygen in use safety signs were required to be posted at the entrance room doors for all residents with oxygen equipment. Interview on 01/30/24 at 9:16 A.M. with DON indicated after surveyor identification of the missing oxygen in use safety signs during the survey, additional signs were obtained and now applied to the entrance room doors for Residents #10, #21, #22, #34, #47, #48 and #64. Review of facility policy, Oxygen Administration, revised October 2010, revealed to place an oxygen in use sign on the outside of the room entrance door. 366447 Page 2 of 2