Failure to Ensure Timely Physician Visits
Penalty
Summary
The facility failed to ensure that residents received the required physician visits as mandated by regulations. Specifically, the facility did not consistently ensure that physician visits occurred at least once every 30 days for the first 90 days after admission and at least once every 60 days thereafter. This deficiency was observed in six residents, where either the initial comprehensive visit was not conducted by a physician or the frequency of visits did not meet the required schedule. For instance, one resident was admitted with multiple diagnoses, including dementia and chronic kidney disease, but did not receive timely visits from the assigned physician. In several cases, the initial comprehensive visit was conducted by a Nurse Practitioner (NP) instead of the assigned physician, which is against the required protocol. For example, one resident with acute and chronic respiratory failure had their first visit conducted by an NP rather than the physician. Another resident with congestive heart failure also had their initial visit conducted by an NP, with the physician only consulting two days later. These actions indicate a failure to adhere to the required protocol for initial comprehensive visits by a physician. Additionally, there were instances where residents expressed concerns about not being seen by their physician, and the facility's documentation did not reflect timely physician visits. One resident, who had been at the facility for about two years, reported not being seen by their doctor despite requesting a visit. The facility's records showed significant gaps between physician visits, with some residents not being seen for several months. Interviews with staff, including the Director of Nursing and a Nurse Practitioner, revealed a lack of adherence to the required schedule for physician visits, further contributing to the deficiency.