Failure to Timely Act on Neurology Referral for Resident with Parkinson's Disease
Penalty
Summary
The facility failed to ensure that a physician's order for a neurology referral was acted upon in a timely manner and monitored for completion for a resident with Parkinson's disease and multiple sclerosis. Despite repeated requests from the resident's representative at care conferences over several months, and documentation in care conference notes and progress notes indicating the need for a neurology appointment due to increased tremors, the facility did not schedule an appointment. The care plan was not revised to address the resident's increased symptoms or the need for a neurology referral. Referrals were sent twice to the resident's previous neurologist, but both times the neurologist's office responded that they could not see the patient due to insurance issues and lack of recent visits. No referrals were sent to other neurologists in the area. The Transportation Coordinator, responsible for coordinating referrals, only sent referrals to the previous neurologist as directed by information from nursing staff, and this process was not monitored by clinical leadership. The Director of Nursing and Unit Manager confirmed that the resident did not have an appointment scheduled and that the referral process was not adequately overseen or documented.