Failure to Implement Physician-Ordered MRI Scan
Penalty
Summary
A deficiency occurred when the facility failed to implement a physician-ordered follow-up MRI scan for a resident with a history of glioblastoma removal and traumatic brain injury. The resident, who exhibited behavioral changes and required constant monitoring, was admitted to the memory care unit and had recently returned from the hospital with an order for an MRI. Documentation showed that the MRI was scheduled, the need for an escort was noted, and the necessary pre-procedure medication (Ativan) was ordered. The resident's wife provided the relevant paperwork to an LPN, and the appointment was entered into the facility's appointment book. However, the scheduled MRI appointment was subsequently crossed out in the appointment book without explanation, and the procedure was not completed as ordered. Interviews with staff revealed that the appointment was canceled by the previous DON, but no reason was documented. The nursing home administrator confirmed that the facility did not follow through with the physician's order for the MRI scan for this resident.