Failure to Ensure Effective Medical Director Coordination and Timely Response
Penalty
Summary
The facility failed to ensure that the medical director effectively coordinated medical care, as evidenced by a lack of timely response to nursing staff requests for direction regarding a resident's care. One resident experienced ongoing symptoms, including a severe headache, nausea, and persistent bradycardia, with documented pulse rates as low as 44 beats per minute over several days. Despite repeated attempts by nursing staff to contact the medical director about the resident's slow pulse, calls were not returned promptly, and the resident's condition was not addressed in a timely manner. Interviews with staff revealed that the medical director was only present at the facility once per month and was difficult to reach, with calls often going unanswered for several days. The process for addressing concerns with the medical director's performance was lacking, and there was no established method for managing issues related to the medical director's care of residents. Ultimately, the resident required emergency room care, where new medical orders were provided, including discontinuation of a medication and referral to a cardiologist.