Failure to Obtain Ordered Laboratory Services for a Resident
Penalty
Summary
The facility failed to obtain laboratory services as ordered for one of three residents. According to the facility's policy, laboratory tests are to be obtained, processed, reviewed, and acted upon in a timely manner by qualified staff. A resident with chronic kidney disease, heart failure, high blood pressure, and psoriasis was evaluated by a dermatologist, who determined that systemic medication was needed for uncontrolled psoriasis. The dermatologist ordered blood work to be completed prior to starting the medication. However, review of the clinical record showed no documentation that the required blood tests were completed within the specified timeframe. Progress notes indicated that the resident inquired about the bloodwork, but staff could not locate any related orders initially. Later, the dermatology office confirmed that labs were ordered and needed to be completed before starting the medication. Although a laboratory order was eventually entered, the blood drawn was related to an unrelated order, and there was no documentation that the correct blood tests were completed. Both the Nursing Home Administrator and the resident confirmed that the required blood tests had not been completed as ordered.