Failure to Provide Timely Radiology Services Following Provider Order
Penalty
Summary
The facility failed to provide timely radiology services as ordered for one resident who experienced chronic coughing. After the resident reported coughing spells, a nurse practitioner evaluated the resident and ordered a chest x-ray as part of the treatment plan. The order was not immediately entered into the electronic medical record; instead, it was entered two days later by a nurse after a verbal order was relayed. Despite the order being in the system, the chest x-ray was not completed, and there were no results available for the resident. The nurse responsible attempted to contact the contracted radiology company twice during their shift and endorsed the need for follow-up to the oncoming shift, but the x-ray was still not performed. Facility staff interviews revealed that nurses are expected to acknowledge and confirm new orders in the electronic medical record, and if an order is not seen, they are to verify with the provider or consult with nursing leadership. Documentation showed that the resident continued to complain of cough and was still due for the chest x-ray several days after the order. Ultimately, the resident called emergency services for hospital evaluation. The facility's own policy requires that radiology and diagnostic services be provided promptly to meet residents' needs, but this was not followed in this case.