Failure to Implement Physician-Ordered Mobility and ROM Programs
Penalty
Summary
The facility failed to provide physician-ordered services to maintain a resident's mobility and range of motion for three residents. Resident 71, who was planning to return home, had completed 12 weeks of therapy and was placed on a restorative nursing program for ambulation and lower extremity exercises. However, the facility did not consistently follow through with the prescribed ambulation program, as evidenced by incomplete documentation and insufficient ambulation distances recorded. There was no evidence that the recommended standing exercises were ordered or completed, and no communication was provided to indicate any issues with completing the program. Resident 11 was readmitted from a hospital stay with a physician's order for therapy screens to determine her care needs. The facility did not complete these screens, and her range of motion declined without any documented interventions. Initially assessed as having no range of motion limitations, subsequent assessments showed limitations in both upper and lower extremities, yet the facility did not implement any interventions to address this decline. Resident 14, who had a stroke resulting in left-sided weakness, reported not receiving the promised exercises from the nursing staff. Her care plan included participation in therapy and a restorative nursing program for range of motion, but there was no evidence that these programs were implemented. The facility confirmed the lack of evidence for the implementation of the recommended range of motion program for Resident 14.
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 11, 14 and 71 have been evaluated by therapy to provide needed services and identify appropriate restorative program. 2. Whole house audit of residents discharged from therapy in the last 2 months with an ambulation and ROM program to ensure programs are on Kardex. Audit of previous month of MDSs to review for any residents with a decline in ROM and ensure appropriate intervention occurred. 3. Education to Restorative Nurse Coordinator about ensuring all RNPs are added to Kardex. Education to RNACs to elevate any coded declines of ROM to IDT. 4. Random audit of 3 residents coming off therapy caseload weekly x4 then monthly x2 to confirm ordered RNP on Kardex. Random audit of 3 MDS weekly x4 then monthly x2 to monitor for any decline in resident ROM. 5. Compliance date: January 28, 2025.