Failure to Timely Schedule Dermatology Appointment per Physician Order
Penalty
Summary
The facility failed to follow physician orders for a resident with a persistent body rash by not scheduling a dermatology appointment in a timely manner. The physician's order, dated 03/26/2025, directed staff to arrange a dermatology consultation due to a rash that was not improving. However, no attempts were made to schedule this appointment until 04/15/2025, nearly three weeks later. Facility policy required the clerk to coordinate and document resident appointments, but there was no documentation of any contact attempts or scheduling activity during this period. The resident's care plan included interventions to manage the rash and prevent complications, but the necessary specialist referral was delayed. The resident involved had a complex medical history, including Parkinson's disease, hypertensive heart disease, multiple psychiatric diagnoses, and moderate cognitive impairment. Observations during the survey noted red, inflamed splotches on the resident's arms. Interviews with staff revealed that the clerk responsible for scheduling appointments was aware of the order but had prioritized other tasks and had not acted on the referral promptly. Both the DON and Administrator confirmed that the expectation was for specialist appointments to be scheduled and documented without delay, but this did not occur in this instance.