Failure to Implement Restorative Nursing Program for Resident with Limited ROM
Penalty
Summary
The facility failed to implement a restorative nursing program for a resident with limited range of motion, as recommended by therapy. Resident 108, who was admitted with hemiparesis following a cerebral infarction affecting her right side, was not provided with the necessary passive and active range of motion exercises. These exercises were recommended by physical therapy to maintain her ability for clothing management and daily hygiene tasks. Despite the therapy discharge documentation noting that staff were trained to perform these exercises, there was no evidence in the clinical record that the program was implemented. An interview with the resident confirmed that she no longer received physical therapy, and an interview with the physical therapist revealed that a range of motion program was never established for her. Additionally, nursing staff were not educated on the program. These findings were confirmed with the Director of Nursing, indicating a lapse in the facility's responsibility to provide appropriate care to maintain or improve the resident's range of motion.
Plan Of Correction
1. Resident 108 to be re-evaluated by therapy to make sure appropriate for RNP program to the lower extremities. 2. DON/Designee will audit the past 30 days of therapy discharges to an RNP to identify if other residents been affected. 3. DON/Designee will educate Therapy on 483.25(c) (3), and policy named Restorative Policy. 4. Rehabilitation supervisor/Designee will do an audit weekly x4 and monthly x3 to assure that RNP programs were communicated with nursing staff to implement. Results of the inspections will be submitted to the QAPI team. 5. Date of compliance 1/30/25.