Failure to Provide Reliable Transportation for Dialysis Appointments
Penalty
Summary
The facility failed to ensure that a resident dependent on renal dialysis was provided with reliable transportation to and from dialysis appointments. Upon admission, the resident had multiple diagnoses including a left fibula fracture, acute pain, diabetes with neuropathy, and end-stage renal disease requiring dialysis three times a week. Physician orders specified the resident's dialysis schedule and the need to be ready for transportation at a set time. Despite this, documentation showed that the resident missed scheduled dialysis sessions due to lack of transportation, and nursing notes confirmed that the resident reported not having transportation available. Further review revealed that the resident was informed by facility staff that she was responsible for arranging her own transportation, and she was provided with a list of transportation companies. The resident, who used a wheelchair, faced challenges in securing appropriate transport, as some services like Uber and Lyft were not equipped to assist her. The facility's plan of care indicated that a specific transportation provider was to be used, but this was not consistently arranged, resulting in missed dialysis sessions and the resident having to use private cars for transport on several occasions. Interviews with the resident and staff confirmed that the resident missed dialysis appointments two or three times due to transportation issues when first admitted. The facility's transportation policy stated that it would arrange transportation for medically necessary appointments, but this was not followed in the resident's case. The deficiency was identified through review of records, interviews, and progress notes, which documented the lack of reliable transportation and the resulting missed dialysis treatments.