Failure to Obtain Ordered Gastroenterology and Infectious Disease Consults
Penalty
Summary
The facility failed to obtain required gastroenterology and infectious disease consultations for a resident who was reviewed for consults. The resident was admitted with multiple diagnoses, including dysphagia, peripheral vascular disease, anxiety, hepatitis C, hepatitis B, COPD, severe protein calorie malnutrition, alcoholism, diabetes, insomnia, sinusitis, and thyroid disease. The resident was cognitively intact and independent in transfers and bed mobility. A physician progress note documented the need for chronic disease management, specifically hepatitis C, and discussed the need for a colonoscopy and GI follow-up, to which the resident agreed. Despite active physician orders for a gastroenterology consult for colonoscopy and a consult for evaluation and management of chronic hepatitis C, these consults were not carried out. The Director of Nursing confirmed that the consults had not been followed through. A review of the facility's physician orders and clarification orders did not show any documentation addressing the completion of these physician-ordered consults.