Failure to Provide Timely Laboratory Services Due to Vendor Non-Payment
Penalty
Summary
The facility failed to provide timely laboratory services for five residents, resulting in missed or delayed lab tests as ordered by physicians. For one resident, a urinalysis was ordered to rule out a urinary tract infection due to new delusions and hallucinations, but the sample was not collected, and there was no documentation of follow-up or physician notification regarding the missed test. Another resident did not have a Hemoglobin A1C test completed as ordered, with no documentation in the medical record or treatment administration record indicating the lab was drawn or any result received. Two residents receiving Depakote for mood and behavioral management did not have their Depakote levels drawn as ordered. The orders specified that the Depakote level should be drawn on the night shift, but the tests were not completed on the specified dates. In one case, the Depakote level was eventually obtained two days after the order, and the result was reported as low. Additionally, a complete metabolic panel (CMP) was ordered for one of these residents but was not documented as completed. Another resident with a history of diabetes had an order for a Hemoglobin A1C, but there was no evidence the test was performed or results obtained. A further resident with a recent toe amputation and gangrenous tissue was to have a CBC and CMP drawn for ongoing monitoring, but these labs were not collected as ordered. Instead, a basic metabolic panel (BMP) was drawn several days after the order, and there was no documentation that the correct labs were obtained. Staff interviews confirmed that the facility experienced issues with laboratory services due to vendor non-payment, resulting in missed lab draws and lack of follow-up or documentation regarding the missed tests.