Failure to Obtain Timely Physician Signature on Florida DNR Orders
Penalty
Summary
The facility failed to ensure that the physician signed the State of Florida Do Not Resuscitate (DNR) order in a timely manner for three residents who had chosen DNR status. In each case, although the residents or their representatives expressed their wishes and, in some instances, signed the state-specific yellow DNR form, the required physician signature was not obtained promptly. For one resident, a DNR order was initiated and documented in the medical chart, but the corresponding Florida DNR form was not signed by the physician. Staff interviews revealed that the care plan was not updated, and the state-specific form was not signed by either the resident or the physician until much later. For two other residents, the state-specific DNR forms were signed by the residents or their responsible parties, but the forms were not present in the medical chart as required and were later found unsigned in the physician's folder. The Director of Nursing confirmed that the Florida DNR form is necessary for resident transport and should be signed by both the resident and physician and placed in the chart. The facility's failure to obtain timely physician signatures on the DNR forms resulted in incomplete documentation of residents' advance directives.