Failure to Schedule Timely Cardiology Appointment for Resident with CHF
Penalty
Summary
The facility failed to ensure that a resident with chronic ischemic heart disease and acute diastolic congestive heart failure (CHF) received a timely cardiology appointment as ordered by the physician. Medical record review showed that after experiencing shortness of breath and chest pain, the resident was evaluated by a nurse practitioner, who ordered an EKG and a follow-up with a cardiologist. Although the facility faxed a consultation request to cardiology, there was no evidence that an appointment was scheduled or that the resident was seen by a cardiologist over a period of several months. Interviews with the resident, transportation aide, and Director of Nursing confirmed that the cardiology appointment had not been made, despite ongoing symptoms and physician orders. The transportation aide noted previous issues with missed appointments and acknowledged that no further attempts were made to schedule the cardiology consult after the last fax. Facility policy required staff to schedule and arrange transportation for medical appointments, but this process was not completed for the resident in question.