Failure to Arrange Timely Cardiology Consult for Resident with LV Thrombus
Penalty
Summary
A deficiency was identified when the facility failed to provide timely access to outside professional services for a resident who required specialized care. The resident was admitted following a cerebral vascular accident (CVA) caused by a left ventricular (LV) thrombus and was discharged from the hospital with instructions to continue anticoagulation therapy for at least three months, with a follow-up cardiology assessment and repeat imaging recommended. Review of the resident's medical records showed that, over the course of a year, there was only one physician note referencing the need for an outpatient cardiology consult, and no orders were placed to arrange this consult. Interviews with the attending physician and the Director of Nursing (DON) revealed a lack of follow-through on the recommendation for a cardiology appointment. The attending physician stated that while recommendations could be made verbally or in writing, it was the facility's responsibility to ensure the appointment was scheduled. The DON was made aware of the concern regarding the absence of a cardiology consult for the resident, highlighting a breakdown in coordination and follow-up for required outside professional services.