Failure to Notify Physician Leads to $300,000 Fine

A nursing home in Tennessee was fined nearly $300,000 after a survey revealed that the facility had failed to notify a resident’s physician of wound treatments that were not performed on residents. This failure prompted the surveyor to place the nursing home in immediate jeopardy on grounds of violating F-Tag F 580, which says that a facility must, among other things, consult with a resident’s physician if there is “A significant change in the resident’s physical, mental, or psychosocial status (that is, a deterioration in health, mental, or psychosocial status in either life-threatening conditions or clinical complications).”



During the course of surveying this nursing home in Tennessee, the surveyor found that the facility had failed to notify residents’ physicians of newly developed pressure and non-pressure related wounds; missed wound treatments; missed medications related to wound care; and changes in wound status for 5 of 13 sampled residents reviewed for pressure and non-pressure related wounds.


The facility's failure to notify the physicians of wound treatments that weren’t performed resulted in a finding of immediate jeopardy because one resident’s arterial wound deteriorated; another resident developed an unstageable pressure ulcer; and another resident developed a deep tissue injury, which is a purple or maroon localized area of discolored intact skin or blood-filled blister.


A finding of immediate jeopardy can be devastating to a nursing home, as such citations typically result in a civil monetary penalty ranging from $3,050 per day to $10,000 per day and may be imposed retroactively to the date of the incident. In this case, a fine of nearly $300,000 was imposed.


In addition, a facility cited for immediate jeopardy only has 23 days to resolve the situation. If a surveyor conducts a revisit survey and the situation hasn’t been addressed by that time Medicaid termination will go into effect.


Given the severity of the financial consequences to nursing homes and other skilled nursing facilities (SNF’s) that are found to be in immediate jeopardy it’s crucial to stay in compliance with all the relevant healthcare rules and regulations. Clearpol’s Policies.ai software can help SNF’s stay on top of the ever-changing and complex healthcare regulatory landscape. Having robust healthcare compliance policies and procedures in place will not only protect the health of patients, but also stave off serious financial penalties.

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