Failure to Ensure Resident Right to Choose Attending Physician
Penalty
Summary
The facility failed to ensure that residents were afforded their right to choose their attending physician, as required by federal and state regulations. For two residents, the facility assigned attending physicians from a pre-selected panel without involving the residents or their families in the decision-making process. In one case, a resident with multiple complex medical conditions, including immunodeficiency, diabetes, hypertension, COPD, and cancer, was admitted under the care of a physician from the facility's panel, despite the resident's family requesting a different physician who had previously cared for the resident for 27 years. The family was informed by the business office that only panel physicians could be selected and was not provided with instructions on how to request an outside physician. Facility staff, including the Director of Business Development, Medical Records Director, and Social Services Director, were unaware of the family's request and did not facilitate the process for credentialing or reactivating the requested physician, who had previously been credentialed at the facility but was no longer active in the system. In another instance, a resident admitted for physical therapy following a hospital stay was assigned an attending physician from the facility's panel without being informed of the right to choose a physician. The resident reported not being involved in the selection process and was unaware that such a choice was available. Interviews with facility staff revealed a lack of consistent procedures for informing residents of their rights regarding physician choice and for processing requests for non-panel physicians. Staff responses indicated that requests for outside physicians would require written statements and credentialing, but there was no evidence that residents or families were guided through this process. A review of the facility's policy confirmed that residents have the right to choose their attending physician and participate in care decisions. However, the facility's practice of assigning physicians from a limited panel, without informing residents of their rights or providing a clear process for requesting outside physicians, resulted in residents not being involved in the selection of their attending physician. This deficiency was identified through interviews, record reviews, and policy examination, demonstrating a failure to uphold residents' rights as outlined in facility policy and regulatory requirements.