Failure to Facilitate Resident and Responsible Party Communication With Physician
Penalty
Summary
The deficiency involves the facility’s failure to ensure a resident and her responsible party were able to communicate with the attending physician as requested, thereby not upholding their rights to communication and access to services. The resident was admitted with cognitive communication deficit, urinary retention, and obstructive and reflux uropathy, had an indwelling catheter, and was always incontinent of bowel movements. Her history and physical indicated she was capable of making medical decisions, and the MDS showed moderate cognitive impairment but an ability to understand and be understood, with active participation by the resident and family in the assessment process. On one date, nursing progress notes documented that the physician and nurse practitioner were notified about the responsible party’s request for communication regarding the resident’s medical condition and that the clinical team would follow up. Later that same day, at the nursing station, the responsible party directly requested to speak with the physician, and the RN stated she would notify the physician and ensure contact was made. The resident also stated she wanted to speak with the physician and had requested that the RN have the physician call her or the responsible party, and she was still awaiting that call. In a subsequent interview, the physician reported that neither he nor his office had been contacted by the facility about the responsible party’s request and that he had not spoken with the responsible party. The NP stated she had not been notified of the request and had never spoken with the responsible party on the physician’s behalf. Review of the nursing progress notes with the RN and the DON showed documentation that the physician was notified of the request but no documentation of any follow-up to ensure the request was honored, and the RN acknowledged she did not know if the physician responded and stated she did not have time to follow up. The facility’s resident rights policy stated that residents have the right to communicate with and access people and services inside and outside the facility and to be supported in exercising their rights.
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