Failure to Ensure Timely Required Physician Visits After Admission
Penalty
Summary
The deficiency involves the facility’s failure to ensure that a resident and physician met face-to-face at all required visits during the first 90 days after admission, as required by facility policy. The facility’s “Physician Visits and Physician Delegation” policy, revised 7/27/25, states that the physician should see a resident within 30 days of initial admission and that the resident must be seen at least once every 30 calendar days for the first 90 calendar days after admission. Record review for one resident (R6), who was admitted on an unspecified date and had diagnoses including vascular dementia, hemiplegia, cerebral infarction, and diabetes, showed that R6 was not seen by a physician within 30 days of admission (including a 10‑day grace period) and was not seen every 30 days thereafter during the first 90 days. R6’s MDS dated 12/30/25 documented a BIMS score of 6/15, indicating severe cognitive impairment. The initial post‑admission visit was completed by an Advance Practice Nurse Prescriber (APNP) on 2/20/25 rather than by a physician, and subsequent physician visits occurred on 4/8/25 and 6/10/25, leaving a missed physician visit in May 2025. In an interview on 1/20/26, the Nursing Home Administrator confirmed that R6 was not seen by a physician for the initial visit and that a required physician visit was missing in May 2025. These findings show that, for this resident, the facility did not follow its own policy requiring timely, face‑to‑face physician visits within the first 90 days after admission, resulting in missed and delayed physician evaluations documented through staff interview and medical record review.
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