Failure to Ensure Timely Physician and NP Assessments
Penalty
Summary
The facility failed to ensure that residents were seen face-to-face by a Medical Doctor (MD) or Nurse Practitioner (NP) at all required intervals, as outlined in the facility's policy and procedure. Record reviews and resident interviews revealed that seven residents had not consistently received timely assessments by an MD or NP. Several residents reported not having seen their MD or NP for extended periods, ranging from several months to over a year. Documentation in progress notes showed that while NPs had entered assessments, there were significant delays between the actual assessment dates and the dates the notes were electronically signed, and residents' recollections did not align with the documented visits. Interviews with staff, including the Assistant Director of Nursing (ADON) and a Licensed Vocational Nurse (LVN), confirmed that there had been ongoing complaints from both residents and staff regarding the lack of regular visits by the MD or NP. Some residents stated they had never met their MD or NP, while others recalled only sporadic visits since their admission. The Director of Nursing (DON) stated she was not aware of these concerns but expected residents to be seen for their assessments as required. A review of the facility's policy indicated that residents should be visited by their physician at least every 30 days, with each visit documented in a progress note. The failure to adhere to this policy resulted in incomplete and potentially outdated medical records, as events were not always recorded in chronological order or within the required timeframes. This deficiency was identified for all seven residents reviewed, indicating a systemic issue with compliance to required physician and NP visits and documentation.