The resident had undergone knee replacement surgery and was taking blood thinners, putting them at risk for dangerous blood clots. Federal inspectors found that despite staff awareness of the refusals, no licensed nurse ever contacted the provider for clarification about the compression stocking orders.
Staff B, the outgoing director of nursing services, told inspectors during a November interview that compression stockings should typically be put on in the morning and removed at night unless specific orders dictate otherwise. She acknowledged being familiar with the resident and knowing about the refusals.
"Staff B stated they were not sure if any licensed staff ever contacted the provider about the clarification of the compression stockings or that they were refusing to allow them to be removed," the inspection report stated.
The nursing director confirmed that staff knew the resident was on blood thinners and at risk for clots. Yet the facility failed to incorporate post-knee replacement surgery protocols into the resident's care plan, conduct any assessment or monitoring for blood clots, or document the treatment refusals.
When inspectors interviewed the administrator and incoming director of nursing services, both confirmed there was no notification, documentation, care planning, monitoring or assessment of the resident's right leg or foot after surgery. Neither provided additional information about the oversight.
The problems extended beyond one resident.
Resident 2, admitted after left knee replacement surgery, had doctor's orders for compression socks on every shift and monitoring for swelling starting October 28. But the care plan showed no interventions for either the compression socks or swelling checks.
Resident 3, admitted with a right hip fracture, had orders for compression socks every morning starting October 13. Their care plan also lacked any interventions for the compression stockings.
Staff D, a licensed practical nurse serving as resident care manager, acknowledged during the inspection that residents with compression sock orders should have those interventions included in their care plans.
The violations represent a breakdown in basic post-surgical care coordination. Compression stockings are commonly prescribed after orthopedic surgeries to prevent blood clots, a potentially fatal complication. When residents refuse prescribed treatments, facilities are required to document the refusals and notify physicians so alternative approaches can be considered.
The facility's failure to update care plans meant nursing staff lacked written guidance on how to handle the compression stocking protocols. Without proper documentation of refusals, providers remained unaware that prescribed treatments weren't being administered as ordered.
For the resident taking blood thinners after knee surgery, the combination of medication and immobility already elevated clot risk. The refusal to remove compression stockings at night, if left unaddressed by medical providers, could have led to circulation problems or other complications.
The inspection found "actual harm" to a "few" residents, indicating inspectors determined the care failures caused measurable negative health outcomes.
Life Care Center of Mount Vernon operates at 2120 East Division Street. The facility was cited for failing to ensure comprehensive care plans were developed and implemented according to federal regulations governing nursing home operations.
The November 18 complaint inspection revealed systemic gaps in care plan management that affected multiple residents recovering from major orthopedic procedures. All three residents identified in the report required post-surgical monitoring that the facility failed to properly coordinate or document.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Life Care Center of Mount Vernon from 2025-11-18 including all violations, facility responses, and corrective action plans.
Additional Resources
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