Failure to Obtain Proper Consent and Inform Residents of Monitoring System Features
Penalty
Summary
The facility failed to ensure the rights of three residents to self-determination and informed consent were upheld when a contactless cardiorespiratory monitoring system with a microphone and speaker was installed and activated in their rooms without proper consent or adequate explanation. Residents were unaware of the device's true function, believing it to be a night light, and did not know it was monitoring their heart rate and respirations or that it contained a speaker. One resident's consent was signed by a family member, but the resident herself was not aware of the consent or the device's capabilities. Another resident had not signed any admission papers, and a third had denied consent, yet the monitoring system was still activated in their rooms. Interviews with staff revealed a lack of training and awareness regarding the monitoring system. The Director of Staff Development had not provided in-service education to staff about the system, and both the Director of Nursing and the admissions coordinator were unaware that the device included a speaker. Staff members, including LVNs and CNAs, expressed concerns about privacy and agreed that residents should be informed about the monitoring system and its features. The admissions coordinator confirmed that the informed consent form did not mention the presence of a speaker, and the system was activated in residents' rooms without their full understanding or agreement. Facility policy required that residents or their representatives be educated about the monitoring system and that consent be obtained prior to activation. However, the process for obtaining and documenting consent was inconsistent, and the information provided to residents was incomplete. The monitoring system was used to collect and transmit residents' vital sign data, but residents were not adequately informed about the nature of the monitoring or the presence of audio features, resulting in a violation of their rights to dignity, self-determination, and privacy.