Failure to Provide Ongoing Treatment and Follow-Up for Persistent Skin Rash
Penalty
Summary
A resident with severe cognitive impairment was admitted to the facility and developed a skin rash. The nurse practitioner (NP) assessed the resident and prescribed a one-time dose of Permethrin 5% cream for suspected scabies, with a plan to reevaluate the rash after treatment. However, there was no documented follow-up or reassessment by the NP as planned, and no additional treatments for itching were ordered. The resident continued to experience symptoms, including itching and the spread of the rash to multiple areas, as observed during interviews and skin assessments. Despite the resident's ongoing symptoms and reports of discomfort, staff interviews and record reviews confirmed that no further interventions or dermatology consultations were initiated in a timely manner. The unit manager and medical director were unaware of any additional treatment orders or scheduled dermatology visits, and the resident did not receive further care for the persistent rash. This lack of follow-up and failure to provide appropriate ongoing treatment according to the resident's needs and the NP's plan resulted in the resident remaining symptomatic.