Failure to Ensure 24-Hour Physician Availability for Emergency Care
Penalty
Summary
The facility failed to ensure the provision of physician services 24 hours a day in the event of an emergency for one resident. On the evening in question, a resident complained of severe abdominal pain and emesis, and the nurse on duty assessed the resident, determining that the resident was not in distress at that time. The nurse attempted to contact the on-call physician through the telehealth service but did not receive a timely response after calling twice. While waiting for a response, the resident's representative was informed of the situation and ultimately transported the resident to the emergency room without a physician's order, as the nurse was still awaiting a callback from the practitioner. Documentation in the medical record indicated that the resident was later admitted to the hospital for a bowel obstruction and hypotension. Staff interviews confirmed that the nurse took the resident's complaint seriously and followed protocol by attempting to contact the on-call provider, but the lack of timely physician response led to the resident being transported by the representative. The facility administrator acknowledged that the on-call practitioner should have been available and responded in a reasonable timeframe.