Failure to Provide Timely Follow-Up for Dental and Urology Services
Penalty
Summary
The facility failed to ensure timely follow-up and coordination of medically-related social services for a resident with multiple complex diagnoses, including cerebral infarction, heart failure, chronic kidney disease, gout, and aphasia. The resident was severely cognitively impaired and fully dependent on staff for activities of daily living. Despite recommendations for dental services, including tooth extractions and dentures, the Social Services Director did not follow up on the necessary authorizations for several months. The dental company scheduled appointments, but the Social Services Director did not verify whether the services were completed, resulting in a significant delay and the need to obtain a new authorization. Additionally, the facility did not ensure that the same resident attended a scheduled urology follow-up appointment, which was necessary to confirm the resolution of a urinary tract infection. The Licensed Vocational Nurse entered the appointment order into the facility's system and provided it to Social Services, who were responsible for arranging transportation. However, there was no documentation explaining why the resident missed the appointment, and neither the Social Services Designee nor the Social Services Assistant could provide records or notes verifying communication with the transportation provider. The absence of documentation and lack of follow-up led to the missed appointment. Interviews with staff, including the Director of Nursing, confirmed that there was no explanation or documentation for the missed urology appointment and that the Social Services team did not track or verify completion of outside appointments. The facility's policies required prompt referral and follow-up for medically-related social services, but these were not followed in the resident's case, resulting in delays in necessary care and services.