Dorcas House

Based on record review and interview, the director of nursing failed to ensure a nurse notified a resident's designated medical practioner as soon as possible, but not more than 24 hours, after a resident had a significant change in condition and required medical services. The deficient practiced posed a health risk to a resident if the physician was unaware of a significant change in condition, which required medical services. Findings include: 1. In record review, R1's medical record included documentation R1 was sent to the hospital on November 17, 2024, after having an elevated heart rate, increased temperature, distress, episodes of diarrhea, Tachycardia along with respiratory distress, and concerns of dehydration. R1 was diagnosed with a urinary tract infection. 2. In record review, R1's medical record did not include documentation a nurse notified R1's designated medical practitioner of the resident's change in condition and hospitalization. 3. In record review, R2's medical record included documentation R2 was sent to the hospital on November 13, 2024, after having an elevated temperature. R2 had a central line port. "Pt evaluated ... admitted ... for Tachycardia, fever with central line." R2's record included documentation "... CT abdomen with contrast shows acute on chronic pancreatitis, pt + for adeno & rhotovirus (sic)..." 4. In record review, R2's medical record did not include documentation a nurse notified R2's designated medical practitioner of the resident's change in condition and hospitalization. 5. During an interview, E1 reported the residents' physicians requested the facility just send the residents to the hospital (when needed), and do not need to notify the physician. E1 reported the hospital notified the physicians when residents were sent to the hospital. E1 and E2 acknowledged the facility did not notify R1 and R2's physician when they were sent to the hospital, as required.