Failure to Ensure Timely Oncology Follow-Up for Resident with Cancer
Penalty
Summary
The facility failed to ensure that a resident with non-Hodgkin lymphoma received all necessary services, specifically a scheduled oncology appointment as prescribed upon discharge from an acute care hospital. The resident, who also had end stage renal disease, heart failure, and adult failure to thrive, was admitted with orders for outpatient treatment with rituximab and a follow-up appointment with an oncologist. Documentation showed that the resident did not attend the scheduled oncology appointment due to insurance issues, and there was no evidence in the medical record that the primary care physician was notified of the missed appointment or that the appointment was rescheduled. Interviews with the DON and the resident's primary care physician confirmed that facility staff did not follow protocol to notify the physician or reschedule the missed specialist appointment. The facility's policy required timely and coordinated referrals to medical specialists, including documentation and follow-up, but these steps were not taken. As a result, the resident did not receive an evaluation and treatment plan for their cancer as prescribed.