Delay in Obtaining Timely Diagnostic X-ray Services
Penalty
Summary
Facility staff failed to obtain a chest x-ray (CXR) in a timely manner for a resident with multiple significant diagnoses, including Chronic Obstructive Pulmonary Disease, Multiple Myeloma, and Paroxysmal Atrial Fibrillation. The resident, who was cognitively intact, was seen by a nurse practitioner for mild fever and chills, and a CXR was ordered to rule out respiratory infection. The order for the CXR was entered on the same day as a urinalysis, but the CXR was not performed until two days later. Interviews with the Director of Nursing and the nurse practitioner revealed that the delay was not explained by facility staff, and the nurse practitioner stated that the facility was dependent on the radiology company. Review of facility policy and the contract with the mobile imaging provider confirmed that radiology services were to be available 24/7. No additional information was provided by facility leadership to explain the delay prior to the survey exit conference.