Failure to Reschedule Dermatology Appointment as Ordered
Penalty
Summary
Facility staff failed to follow physician orders for a resident who had a recurrent rash on the lower legs. The resident, who had diagnoses including dementia, hypertension, and hypothyroidism, had been prescribed the same ointment multiple times and was under the care of both rheumatology and dermatology for the rash. Medical records showed that the resident was seen by rheumatology and dermatology as ordered, but a dermatology appointment scheduled for February was cancelled due to an elevator malfunction at the hospital. Although there was a physician order to reschedule the dermatology appointment, there was no documentation that the follow-up appointment was ever scheduled. Interviews revealed that the staff member responsible for scheduling appointments and transportation was not notified by nursing to reschedule the dermatology appointment. The attending physician confirmed that the expectation was for the appointment to be rescheduled if missed, and was unaware that it had not been done. The deficiency was identified when it was found that the resident continued to have a rash and lacked current treatment or follow-up with dermatology as ordered.