Failure to Ensure Pacemaker Monitoring for Resident with Cardiac History
Penalty
Summary
The facility failed to ensure the highest practicable care for a resident with a cardiac pacemaker. Upon admission, the resident had diagnoses including coronary artery disease, congestive heart failure, hypertension, and a surgically inserted pacemaker. The resident's care plan included instructions for pacemaker checks, but there was no specified intervention or method for performing these checks. Clinical record review showed no evidence of a current physician's order for pacemaker monitoring, and no documentation that pacemaker checks were being completed. This deficiency was identified when the surveyor discovered the lack of a physician's order and absence of documented pacemaker checks during a review and interviews with facility leadership. The facility confirmed that prior to the surveyor's inquiry, there was no order in place and no evidence that the required pacemaker monitoring was being conducted for the resident.