Failure to Obtain and Complete Ordered Laboratory Tests
Penalty
Summary
The facility failed to obtain and complete laboratory tests as ordered by physicians for three residents. For one resident with multiple complex diagnoses, including cerebral palsy, epilepsy, and dementia, physician orders required regular laboratory monitoring such as CBC, renal panel, Dilantin and Phenytoin levels, lipid panel, liver function tests, hemoglobin A1C, and PSA at specified intervals. Review of the medical record and laboratory results revealed that not all ordered laboratory values were completed as scheduled, and the DON confirmed the missing results. Another resident with chronic obstructive pulmonary disease, neurocognitive disorder, and other conditions had physician orders for periodic lipid panels, hepatic function, CBC, and renal panels. The available laboratory results did not meet the frequency specified in the orders, and the DON verified that no additional results were present. A third resident with extradural and subdural abscess, osteomyelitis, and Arnold Chiari Syndrome had an order for a toxicology drug screen, which was not performed. The DON confirmed the absence of this test result.