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Based on observations and interviews the condition was not met for the Long Term Acute Care Unit where reliable telemetry services were not provided to patients requiring cardiac monitoring.

See A-0144

Based on observations and interviews the condition was not met for the Long Term Acute Care Unit where reliable telemetry services were not provided to patients requiring cardiac monitoring.

The Surveyor toured the Long Term Acute Care Unit (LTAC) unit at 8:40 A.M. on 5/11/2021 and observed the central telemetry screen that was positioned at the Nurses Station. Of the twelve available patient monitoring channels four were in use. Of the four patients being monitored, one monitor indicated normal sinus rhythm, one was a straight line and two were reading a communication error.

The Surveyor interviewed the Unit Secretary on the Telemetry Unit at 8:42 A.M. on 5/11/2021 about the telemetry readings. The Unit Secretary said the nurses were with these patients fixing the telemetry transmissions by changing the patient's leads and the telemetry box's batteries.

The Surveyor revisited the central telemetry screen and interviewed the Chief Clinical Officer at 9:40 A.M. on 5/11/2021. The telemetry readings were recording as described above. The Chief Clinical Officer said the nurses had changed the patient's leads and their telemetry box's batteries already. The Chief Clinical Officer said the telemetry system was an older unit and that the Chief Executive Officer had obtained pricing for a replacement system already. The Chief Clinical Officer said there were problems with the system for approximately the past month but that there were no unfortunate outcomes related to telemetry.

The Surveyor interviewed the Licensed Practical Nurse #1 about the Telemetry Unit at 10:00 A.M. on 5/11/2021. Licensed Practical Nurse #1 said she had spent approximately 10 to 15 minutes already trying to get her patient's telemetry unit to work. Licensed Practical Nurse #1 said she had changed the leads and the batteries but that had not fixed the problem. Licensed Practical Nurse #1 said sometimes it is the telemetry box and some of the telemetry boxes were better than others.

The Surveyor interviewed the Chief Executive Officer at 10:20 A.M. on 5/11/2021. The Chief Executive Officer said the system was at the "end of life" and he had received a quote for a new telemetry system and submitted the quote to the Hospital's central office. Chief Executive Officer said he would address the system immediately.

The Surveyor again interviewed the Chief Executive Officer at 10:30 A.M. on 5/11/2021. The Chief Executive Officer said the telemetry service person was enroute to the Hospital and anyone not being successfully monitored by the central cardiac telemetry was now being placed on a bedside telemetry unit.

The Surveyor interviewed the telemetry service person at 3:30 P.M. on 5/11/2020. The telemetry service person said he was at the Hospital in January for a routine maintenance call and that the Telemetry System was an older unit and he would be checking all of the telemetry boxes and wires.

The Surveyor again interviewed the Chief Executive Officer at 4:00 P.M. on 5/11/2021. The Chief Executive Officer said that the repairs were ongoing and he would transition the bedside telemetry patients back to the central monitoring system when the repairs were complete. The Chief Executive Officer said he would instruct the Nursing Supervisors to place the telemetry patients on the bedside units if the central unit was not working correctly. The Chief Executive Officer said in the future he would also conduct a formal education for the nurses as to how to respond to a telemetry failure.

The Surveyor revisited the central telemetry screen and interviewed the Chief Clinical Officer at 7:10 A.M. on 5/12/2021. The Chief Clinical Officer said that only one patient was on the central telemetry screen because all of the remaining telemetry boxes were sent out for repair and the other telemetry patients were on the bedside units.

The Surveyor passed by Patient #7's room on the LTAC Unit at 11:10 A.M. on 5/12/2021. Patient #7's bedside telemetry unit was alarming as indicated by a red light on the machine; however, the alarm was faint even though the Surveyor was in the patient's doorway. Patient #7's room was located at the end of the hall furthest from the nurse's station.

The Surveyor again interviewed the Chief Clinical Officer at 11:15 A.M. on 5/12/2021. The Chief Clinical Officer said the volume of the bedside cardiac monitor must have been turned down. The Chief Clinical Officer said he would address the issue immediately.

The Surveyor again interviewed the Chief Executive Officer at 2:00 P.M. on 5/12/2021. The Chief Executive Officer said Patient #7 might be discontinued from telemetry however the Chief Executive Officer said he would place the telemetry patients close to the nurse's station so the volume of the alarms could be turned down to facilitate patient comfort but allow staff to readily hear the cardiac monitor alarm.