Failure to Complete Timely Physician Visits for Multiple Residents
Penalty
Summary
The facility failed to ensure that required physician visits were completed in a timely manner, as mandated by state and federal regulations. Specifically, several residents did not receive face-to-face visits from their attending physician or nurse practitioner within the required intervals following admission. For example, three residents were only seen by the physician upon admission and did not have subsequent visits every 30 days as required for new admissions. Another resident was not seen by the physician until approximately three months after admission, with the next visit by the nurse practitioner occurring several months later. Additionally, for four other residents, the facility did not ensure that physician visits were conducted as required. In these cases, residents were either seen only once by the physician or had irregular visits from the nurse practitioner, with significant gaps between visits. Some residents reported not having seen the physician or nurse practitioner in a considerable amount of time. Review of progress notes confirmed these lapses, with documentation showing missed or delayed visits that did not meet the regulatory schedule. Interviews with staff, including the ADON, unit manager, nurse practitioner, and physician, revealed inconsistencies in understanding and implementing the required visit schedule. Staff acknowledged that some residents may have been missed for visits due to oversight, and there was confusion regarding the frequency of required visits, particularly for new admissions. The facility's policy required physician visits at least every 30 days for the first 90 days after admission and at least every 60 days thereafter, but this was not consistently followed for the sampled residents.