Healthcare Compliance Perspective:
Failure to observe a resident’s plan of care could translate into inadequate provision of services and a potential violation of the False Claims Act.
A resident in a north St. Louis County nursing home recently died because a nurse fed the resident in 30 minutes what was supposed to be infused over an hour-long period. The resident choked and died as a result of the too rapid feeding.
Residents who cannot feed themselves or who refuse to eat, frequently receive nourishment through a gastric tube inserted into their stomach. These feedings are supposed to occur over a specified period of time and be supervised.
This was the nurse’s first day on the job at the nursing home; and, along with failing to observe the prescribed instructions for feeding this resident, the nurse did not perform CPR or call 911 when the patient was found unresponsive. The resident did not have a “do not resuscitate” order in the medical record.
In an interview, the nurse said that she infused the resident for 30-minutes, checked vital signs and then left the room. She said that she assumed because of the resident’s vegetative state, there was a do not resuscitate order in place.
The nursing home was cited by CMS investigators for “placing residents in immediate jeopardy and may be fined as a result of the incident. Investigators wrote this in the report-“during that shift, Nurse A was very overwhelmed with trying to learn the facility procedures and there were no other nurses on duty to answer his/her questions … Nurse A knew what was expected of him/her and there was no excuse for failing to follow proper procedure.”
