Failure to Implement Restorative Programs for Residents
Penalty
Summary
The facility failed to maintain or improve the ability of two residents to perform activities of daily living. Resident 24, who had a left leg amputation and was provided with a prosthetic leg, was not using it because the facility did not have parallel bars, which he had used in a previous facility for gait training. The staff used a mechanical lift for transfers and did not incorporate the prosthetic leg into his care plan, despite recommendations from physical therapy for a restorative nursing program that included the use of the prosthetic. Interviews with Resident 24 and his wife, as well as a nurse aide, confirmed the lack of use of the prosthetic and the absence of training for staff on its application. Resident 40, who was discharged from skilled therapy with recommendations to continue a restorative nursing program to maintain lower extremity strength, did not consistently receive these services. Documentation showed that the program was not completed on numerous days, with staff citing the resident was resting as the reason. The Nursing Home Administrator and the Director of Nursing confirmed the inconsistency in completing the restorative nursing program and acknowledged the lack of oversight by licensed staff to ensure the program was carried out as planned.
Plan Of Correction
The Facility submits this Plan of Correction under procedures established by the Department of Health in order to comply with the Department's directive to change conditions which the Department alleges is deficient under State and/or Federal Long Term Care Regulations. This Plan of Correction should not be construed as either a waiver of the facility's right to appeal or challenge the accuracy or severity of the alleged deficiencies or an admission of past or ongoing violation of State or Federal regulatory requirements. 1. Residents 24 and 40 are on therapy caseload to address needs and evaluate for appropriate restorative nursing program. 2. All residents with a prosthetic were reviewed to ensure documented use of prosthetic. All residents on a RNP for ADLs were reviewed for completion of program and elevation to IDT for recommendations for those not completing their program requirements. 3. The Restorative Nursing Coordinator was educated on reviewing program completion of RNP for ADLs and elevating to IDT for recommendations of any programs not completed. 4. Random audit of 5 RNP for ADLs will be completed weekly x4 then monthly x2 with results reported to QAPI. 5. Compliance date: January 28, 2025.