Failure to Ensure Timely and Alternating Physician Visits
Penalty
Summary
The facility failed to ensure that two residents were seen by a physician at the required intervals following admission. For one resident admitted with dementia and chronic kidney disease, the initial physician visit occurred at admission, but subsequent visits were conducted solely by a nurse practitioner (NP) for over a year, with the next physician visit not occurring until more than a year later. The unit manager confirmed that physician visits were not tracked, and the director of nursing acknowledged the expectation for alternating visits between the physician and NP, which did not occur. For another resident admitted with dementia, COPD, and hypertension, the last physician visit was documented at admission, with all subsequent visits completed by the NP. There was also a gap of 74 days between two NP visits, exceeding the required frequency. The director of nursing confirmed that the expected schedule of alternating and timely visits by the physician and NP was not followed for this resident.