Failure to Arrange Timely Transportation for Medically Necessary Appointments
Penalty
Summary
The facility failed to provide appropriate transportation arrangements for a resident requiring a CT scan, resulting in multiple missed appointments and a delay in treatment. The resident, who has a complex medical history including traumatic brain injuries and end stage renal disease requiring dialysis, was dependent on the facility to coordinate transportation due to her use of a wheelchair. Documentation and staff interviews revealed that the transportation coordinator encountered issues with the facility’s ride-hailing service card, which was unavailable for a period, necessitating reliance on insurance-based transportation that required advance notice. Additionally, there were scheduling conflicts with the resident’s dialysis treatments, and a lack of available escorts further contributed to missed appointments. Staff interviews indicated that the transportation coordinator was not always aware of all scheduled appointments and did not consistently arrange transportation in advance. On one occasion, an escort canceled last minute, and the appointment was not rescheduled in a timely manner. There was also confusion and lack of communication among staff regarding the resident’s appointment times and the ability to adjust dialysis schedules to accommodate external medical appointments. The resident missed several appointments due to these coordination failures, including one where transportation was not set up and another where the dialysis schedule could not be changed. Facility records and staff statements confirmed that the resident’s appointments for necessary imaging studies were repeatedly missed or rescheduled due to transportation and scheduling issues. The facility’s own policy stated that it would assist residents in arranging transportation as needed, but this was not consistently followed. As a result, the resident experienced delays in receiving diagnostic imaging required for ongoing neurosurgical care.