Failure to Honor Resident Choice in Blood Glucose Monitoring Method
Penalty
Summary
The facility failed to honor a resident's right to make choices regarding the method of blood glucose monitoring. A resident with a history of diabetes mellitus, neuropathy, aphasia, hemiplegia, cancer, hypertension, hyperlipidemia, arthritis, depression, and cataracts, and who had experienced cognitive decline since admission, was not given the option to continue using a Continuous Glucose Monitoring (CGM) device as previously used. The resident's hospital discharge summary included orders for both traditional Accu-Chek monitoring and CGM supplies, but the facility only implemented Accu-Chek monitoring without consulting the resident or their family about their preference. During interviews, the resident's family expressed concern that the facility did not allow the use of CGM devices and that no choice was offered regarding the monitoring method. Facility staff, including an LPN and the DON, confirmed that CGMs were permitted and used by other residents, and that the expectation was to discuss monitoring preferences with the resident or their representative. However, there was no documentation of such a discussion or a process for CGM use in the facility's policies. Additionally, the facility was unable to provide policies regarding the admission process, order implementation, or resident choice when requested.