Failure to Honor Resident's Request for Hospital Transfer
Penalty
Summary
A deficiency occurred when a resident with multiple diagnoses, including dementia, major depressive disorder, diabetes, and hypertension, complained of increased lower back pain and requested to be sent to the hospital. The resident was assessed by an LVN, who noted a distended and firm lower pubic area, performed an in-and-out catheterization, and contacted the physician, who ordered Rocephin and planned to visit the resident. Despite the resident's explicit request to go to the ER, the LVN did not send her out, instead opting to provide pain medication and monitor her condition. The resident's responsible party was informed of the plan of care and agreed at the time, but later expressed concern that the resident's request to go to the hospital was not honored. Interviews with facility staff, including the LVN, DON, and ADM, confirmed that the expectation was to send the resident to the hospital upon her request, and that failing to do so could result in unmet medical needs. The facility's policy on resident rights supports the resident's right to participate in her treatment and to access services outside the facility. The deficiency was identified based on the failure to honor the resident's request for hospital transfer when she experienced pain, as well as the acknowledgment by staff that this action was expected and not followed.