Failure to Schedule Timely Medical Appointments for Resident
Penalty
Summary
A resident with a history of malignant neoplasm of the nasal cavities, ear, and sinuses, as well as age-related cataracts, was not assisted in obtaining timely medical appointments as ordered and indicated by their medical condition. The resident reported ongoing difficulty in getting follow-up appointments scheduled for both a suspicious bone lesion on the hip and for cataract evaluation, despite repeated requests to staff. Review of the electronic medical record (EMR) confirmed that orders for an ophthalmology follow-up for cataracts and an oncology consultation for a suspicious bone lesion were entered, but no appointments had been scheduled for these services. Progress notes from the nurse practitioner documented the need for these appointments over several weeks, yet the necessary follow-ups were not arranged. The facility's process for scheduling appointments involved nurses filling out forms and management auditing physician orders, but this process failed to ensure timely scheduling for the resident. The Director of Nursing and Administrator acknowledged that the staff member responsible for scheduling appointments had been let go, resulting in missed appointments and a backlog. The nurse practitioner repeatedly communicated the need for these appointments to both the scheduler and nursing staff, but the resident continued to experience delays and expressed frustration over the lack of progress.