Failure to Develop Comprehensive Care Plan for Resident Using Life Vest
Penalty
Summary
The facility failed to develop a comprehensive care plan for a resident who was prescribed a Life Vest, a wearable defibrillator, as part of their treatment for multiple cardiac conditions including hemiplegia, hypertensive heart disease with heart failure, chronic atrial fibrillation, and chronic diastolic congestive heart failure. Although physician orders specified daily battery changes and monitoring of the device for function and placement, the care plan only addressed general cardiovascular status and dietary recommendations, omitting critical aspects related to the Life Vest. Specifically, the care plan did not include interventions for maintaining the cleanliness of the Life Vest, ensuring personal hygiene while using the device, responding to device alarms, or instructions on when to notify the physician. Review of facility policy indicated these elements were required, including daily inspection for cleanliness and fit, assistance with hygiene, and protocols for responding to both non-emergency and emergency alarms. Interviews with staff revealed a lack of clarity regarding responsibility for completing the care plan and an absence of documentation addressing these specific needs.