Failure to Honor Resident's Right to Choose Physician and Treatment
Penalty
Summary
The facility failed to honor a resident's right to choose their attending physician and treatment options. A resident with multiple medical conditions, including a left femur fracture, diabetes, heart failure, chronic kidney disease, peripheral vascular disease, and venous ulcers, expressed a preference to continue wound care with a VA provider rather than the facility's in-house provider. Despite this, the resident was told upon admission to cancel all VA appointments except for orthopedic care and to use only in-house providers. When the resident and their daughter arranged for VA wound care and returned with new treatment orders, the Director of Nursing (DON) instructed staff not to follow the VA provider's orders and had the attending physician discontinue them without the resident's consent. The supplies for the VA-ordered treatments were removed from use and stored away, and the new orders were not transcribed or implemented. Interviews with staff confirmed that the DON directed all care decisions through the medical director and disregarded the resident's expressed wishes and the VA provider's orders. The Social Services Director acknowledged that residents have the right to choose their own physicians, as stated in the admission packet, and agreed that changing provider orders without resident consent was a violation of rights. The Director of Rehab also reported that the DON refused to allow staff to implement the VA provider's orders and removed the related supplies. The Nursing Home Administrator confirmed awareness of the DON's actions and stated that residents have the right to select their providers.