Could repeated failures of staff to respond in a timely manner to a ventilator alarm signaling a potential life-threatening emergency support allegations of fraud, waste and abuse based on substandard quality of care and subsequent submission of false claims for reimbursement that violates the False Claims Act?
Compliance Perspective – Ventilator Alarms
Policies/Procedures: The Compliance and Ethics Officer, the DON and Administrator should review policies and procedures regarding staff responsibility to respond promptly to alarms that indicate emergencies with residents who are dependent on life-support equipment. Training: Staff must be trained to recognize and immediately respond to alarms providing alerts that life-support equipment is malfunctioning. Staff will periodically participate in drills to ensure their competence for responding promptly and appropriately to emergency alarms. Staff should also be trained regarding the criminal ramifications for falsifying business records. Additionally, staff must receive training on F600 Abuse and Neglect and F609 Reporting of Abuse/Neglect. Audit: An audit should be conducted to check all life-support equipment used by residents to ensure that it is fully functional, that all connections are secure, and that the alarms associated with such equipment are operating correctly. The results of the audit and staff response drills should be summarized and submitted to the QAPI/QAA Committee and the Compliance and Ethics Committee for their review and recommendations.
A jury found three nursing home staff guilty of a “Willful Violation of Health Laws for failing to respond to ventilator alarms.” The three convicted were two registered nurses, Sijimole Reji and Annieamma Augustine, and a Certified Nurse Aide (CNA), Martine Morland. The CNA was also convicted of falsifying business records.
The neglect involved an 81-year-old resident who was dependent upon a specialized ventilator unit at the facility. The ventilator became disconnected, but no one responded to the visual and audible alarm. The resident, who was totally dependent upon the staff for her care, could not reconnect the ventilator herself. The ventilator alarm immediately triggered when it became disconnected, notifying nursing staff that the resident was in a life-threatening situation.
All nursing staff were trained to respond immediately whenever a ventilator alarm was triggered. However, the three defendants did not respond. When a different staff person entered this resident’s room, she was discovered unconscious and unresponsive. She was transported to the hospital where she died a day later.
The jury found each of the three defendants guilty of neglect by failing to provide the resident with timely, consistent, safe, adequate and appropriate services, treatment, and care. The CNA was also convicted on a felony charge for making a false entry in an official New York State Department of Health Investigation Summary Report. She falsified the records to conceal the commission of another crime.
