Failure to Timely Obtain and Monitor Ordered Laboratory Tests
Penalty
Summary
The facility failed to obtain and monitor laboratory tests in a timely manner as ordered by the physician for one resident. The resident was admitted with diagnoses including dementia, bipolar disorder, and diabetes, and upon admission, exhibited symptoms such as nausea, vomiting, somnolence, and poor intake. The medical provider identified possible medication or metabolic causes for these symptoms and ordered a series of laboratory tests (CMP, CBC, TSH, Hgb A1C, and valproic acid level) along with IV fluids for hydration. Despite these orders, the laboratory tests were not completed promptly. Provider notes indicated that, nearly two weeks after the initial order, the laboratory results were still pending, and medication was held pending lab results. Review of the resident's records showed that the CMP, CBC, and TSH were not collected until over two weeks after the order, the valproic acid level was not completed until almost a month later, and the Hgb A1C was never collected. Staff confirmed the delays and missing results during interviews and record reviews. The Director of Nursing acknowledged that providers expect labs to be completed in a timely manner when ordered.