Failure to Provide Timely Radiology Services
Penalty
Summary
The facility failed to provide or obtain timely radiology services as ordered by a physician for a resident who was admitted with multiple diagnoses, including coronary artery disease, hypertension, and pneumonia. The resident, who was cognitively alert but experienced short periods of confusion and required assistance with activities of daily living, had a chest X-ray ordered due to a new onset cough. Despite the physician's order, the chest X-ray was not completed on the same day, and there was a delay in both obtaining the X-ray and receiving the results. Nursing documentation showed that the X-ray was ordered as routine, which allowed the contracted X-ray company to delay the service. Staff interviews revealed that the X-ray company often did not prioritize routine orders and sometimes refused to come on weekends, resulting in further delays. The nurse responsible for ordering the X-ray continued to follow up, but the company cited being too busy as a reason for the delay. The physician assistant and DON were both aware of the delay, and the physician assistant attempted to change the order to STAT, but the X-ray company did not process the change in a timely manner. The delay in obtaining the chest X-ray led to a delay in diagnosing and treating the resident's pneumonia. The facility did not have a specific policy or procedure in place for managing X-ray orders and test results, which contributed to the lack of timely follow-up and coordination with the X-ray provider. The deficiency was identified through record review and staff interviews, which confirmed that the facility did not ensure prompt diagnostic services as required.