Failure to Ensure Timely Physician Visits and Signatures on Orders
Penalty
Summary
The facility failed to ensure that physicians conducted required visits and signed physician orders in a timely manner for several residents. Specifically, two residents admitted for short-term stays with Medicare Part A & B coverage did not have documented physician visits or signed physician orders for multiple months following their admission. Physician orders for these residents were received via phone, but there were no physician signatures for the relevant months, and all orders remained flagged for signature. The Assistant Director of Nursing (ADON) acknowledged that the facility's policy, which requires physician visits within specific timeframes and timely signatures, was not followed, despite repeated notifications to the physicians. Additionally, four other residents had unsigned physician orders in their charts. These orders included medication changes, discontinuations, and new prescriptions, all of which were not signed by the physician as required. The facility's policy states that telephone orders must be countersigned by the physician during their next visit, but this was not adhered to for these residents. The ADON confirmed that the policy was not followed in these cases as well. The deficiencies were identified through record reviews and interviews with facility staff, who confirmed the lack of timely physician visits and unsigned orders. The facility's own policies and procedures, which align with state and federal requirements, were reviewed and found not to have been implemented as required for the affected residents.