Failure to Coordinate and Arrange Required Outside Medical Appointments
Penalty
Summary
The facility failed to ensure that required outside professional services were obtained and appointments were coordinated for two residents. For one resident with diagnoses including adjustment disorder, chronic respiratory failure, morbid obesity, dysphagia, and depression, there was an order for an orthopedic consult following the identification of a benign cyst in the right knee. Despite the physician's order, the appointment was not scheduled, and there was no documentation in the nursing progress notes regarding the order or the scheduling of the consult. The resident reported not having the suggested follow-up, and staff interviews confirmed that the appointment was not arranged as required. For another resident with chronic respiratory failure, COPD, diabetes with neuropathy, morbid obesity, and stage 4 chronic kidney disease, there were multiple missed or rescheduled nephrology appointments. The resident required bariatric transportation, and staff interviews and documentation revealed that transportation issues led to the rescheduling of appointments. Although transportation was confirmed for some appointments, others were cancelled or rescheduled, and staff could not consistently recall the reasons for these changes. The facility's own policies required collaboration and documentation for arranging such services, but these were not followed. The deficiency was identified through record reviews and staff interviews, which showed that the facility did not ensure timely scheduling and coordination of outside appointments as ordered by physicians. This affected both residents reviewed for appointment coordination, with failures in both arranging necessary consults and providing appropriate transportation for medical appointments.