Failure to Schedule Appointments and Provide Transportation for Medically Complex Resident
Penalty
Summary
The facility failed to schedule medically necessary appointments and provide transportation for a resident with significant medical needs, including end stage renal disease, breast and lung cancer, and intellectual disabilities. The resident had a documented severe cognitive impairment, as indicated by a BIMS score of 03. Multiple provider notes and appointment records show that the resident missed numerous scheduled appointments for Faslodex (fulvestrant) injections, CT scans, and urology follow-ups due to the facility either not scheduling the appointments, cancelling them, or failing to provide an escort or transportation. Communication between the facility and outside providers repeatedly referenced missed or cancelled appointments, with staff acknowledging the ongoing issue and the need for a caregiver to accompany the resident. The appointment history from April through August shows a pattern of cancelled or missed appointments, including essential cancer treatments and diagnostic procedures. Provider notes document that the facility cancelled several appointments due to lack of an escort and failed to ensure the resident attended scheduled visits. During an interview, the Nursing Home Administrator confirmed the facility's failure to schedule ordered appointments and provide transportation for the resident, resulting in the deficiency.