Failure to Ensure Follow-Up and Documentation for Optometry Services
Penalty
Summary
The facility failed to ensure adequate follow-up regarding optometry services for a resident with multiple cardiac diagnoses, including CHF, ischemic cardiomyopathy, and a history of sudden cardiac arrest. The resident was provided glasses by the facility's contracted optometry service, but later reported, through family, an inability to see out of the glasses. The Social Services Director (SSD) added the resident to the list for the next optometry visit but did not follow up to confirm if the resident was seen or if the issue was resolved. There was no documentation in the resident's medical record regarding vision or optometry services, and the SSD had not received any visit reports from the contracted optometry service since starting at the facility. These actions and omissions resulted in a lack of documented follow-up and unresolved vision concerns for the resident.