Failure to Secure Transportation for Medical Appointments
Penalty
Summary
The facility failed to ensure that residents received appropriate treatment and care by not securing transportation to medical appointments for four residents. The deficiency was identified through a review of facility policies, clinical records, and staff interviews. The facility's policy on 'Special Needs' requires assistance in arranging transportation for services not covered, and the 'Resident Rights' policy emphasizes the right to access services outside the facility. However, the facility did not adhere to these policies, resulting in missed medical appointments for the residents. Resident R1, who was admitted with diagnoses including high blood pressure and dementia, missed critical CT scans and a biopsy due to the lack of a bariatric stretcher for transportation. The transportation issues were attributed to nonpayment to the transport company, which led to the inability to secure necessary transportation. Similarly, Resident R2, diagnosed with dementia and GERD, missed an EGD appointment due to the same transportation payment issues. The facility's failure to resolve these payment issues directly impacted the residents' ability to receive timely medical care. Resident R3, with a history of osteomyelitis, missed several appointments with an infectious disease specialist and a wound care specialist due to transportation complications. Resident R4 also missed a scheduled colonoscopy for the same reason. Interviews with the transportation scheduler and the DON confirmed that the facility's inability to pay the transportation company resulted in these missed appointments, highlighting a significant lapse in the facility's responsibility to provide necessary care and treatment to its residents.
Plan Of Correction
1. The third-party transportation vendor was returned to service. R1, R2, R3, R4 attended their scheduled appointment with no negative effect to care identified. 2. An audit will be conducted to identify Residents who require appointments and to ensure, in the event the in-house fleet is unable to accommodate the trip, that the trip be made timely by a third-party transportation vendor. 3. The NHA will re-inservice the transportation director to ensure Residents who require appointments and to ensure, in the event the in-house fleet is unable to accommodate the trip, that the trip be made timely by a third-party transportation vendor. 4. Residents who require transportation to an appointment will be audited for two weeks by the transportation director. Audit findings will be shared with QAPI.