Failure to Arrange and Document Transportation for Scheduled Medical Appointments
Penalty
Summary
The facility failed to ensure that a resident was taken to scheduled outside medical appointments, as required by physician orders and the resident's care plan. The resident in question was admitted with multiple complex diagnoses, including paraplegia, autonomic dysreflexia, neuromuscular bladder dysfunction, anxiety disorder, chronic pain syndrome, and major depressive disorder. The resident was dependent on staff for all mobility needs and required stretcher transportation due to being bedbound. Upon admission, the resident had existing appointments scheduled and orders for additional appointments, with instructions for staff to arrange transportation. Despite these requirements, a review of the medical record and interviews with staff revealed that the necessary appointments were not scheduled or attended. The process for arranging appointments and transportation involved multiple staff members, including nurses and the transportation coordinator, but there was confusion and lack of clear responsibility. Nurses were responsible for scheduling appointments and notifying the transportation coordinator, who would then arrange transportation. However, conflicting information, missed communications, and lack of documentation led to appointments not being made or attended. Staff interviews confirmed that there were ongoing issues with communication between nursing and transportation staff, resulting in missed appointments. Further review showed no documentation that the resident attended the scheduled appointments or that transportation was arranged. The Director of Nursing and the Administrator confirmed that there was no evidence in the records of appointments being made or attended, and attempts to verify appointments with outside providers were unsuccessful. The facility's policy required assistance with arranging transportation, but this was not carried out as needed for the resident.