Failure to Notify Resident and Representative of Physician Change
Penalty
Summary
The facility failed to honor a resident's right to choose their attending physician by changing the resident's primary care physician without notifying the resident or their representative. According to the facility's Resident Rights Policy, residents are entitled to autonomy and choice regarding their care, including the selection of their physician. The resident was admitted with a specific primary care physician, but the facility switched the resident's physician to the facility's newly hired Medical Director in May 2025. This change was documented in the electronic health record, which showed that the new physician continued to provide care in the following months. Interviews with the resident's family member and representative confirmed that neither was notified, verbally or in writing, about the change in physician. The Assistant Director of Nursing and the Administrator both verified that there was no documentation of notification to the resident or their representative regarding the physician change. The Administrator also stated that the decision to switch all residents to the new Medical Director was made by the facility after the Medical Director was hired.