Failure to Ensure Timely Physician Visits and Oversight of NP Care
Penalty
Summary
The deficiency involves the facility’s failure to ensure that a resident and the attending physician had face-to-face visits within the federally mandated and facility-required 60-day timeframe. The resident, an older adult with vascular dementia, chronic kidney disease, congestive heart failure, atrial fibrillation, and diabetes, was transferred to the hospital on 9/29/2025 and did not return. Record review showed no documentation of a physician visit for more than 60 days prior to this hospital transfer, and the DON could not provide evidence of a required physician visit when requested on 1/24/2026. The only documentation provided was a nurse practitioner (NP) progress note dated 2/17/2025, with no documentation that the attending physician evaluated the resident, supervised the NP visit, delegated care, or reviewed or directed the resident’s medical care. During interview, the primary physician stated that he had not seen the resident, had no records of his NP seeing the resident, and that the last physician notes he saw in the electronic medical record were from another physician’s services dated 2/17/2024, adding that he would not see a resident who belonged to another physician. The facility’s own policy requires residents to be seen by a physician at least every 60 days with an evaluation of the resident’s condition and total program of care, which the facility was unable to demonstrate occurred within the required timeframes. The facility was therefore unable to show compliance with federal requirements and its own policy for timely physician visits and physician oversight of NP services for this resident.
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