Failure to Provide Timely Specialized Rehabilitative Services
Penalty
Summary
The facility failed to provide specialized rehabilitative services in a timely manner for a resident admitted with a history of stroke, left-sided hemiplegia/hemiparesis, contracture of the left hand, and dementia. Upon admission, documentation from the prior facility indicated the resident had been receiving occupational therapy for the left hand contracture, including the use of a palm guard/hand splint and passive range of motion (PROM) exercises. The occupational therapy discharge recommendations specifically advised continuation of splinting and PROM at the new facility. However, upon review, there was no physician order for a palm guard/hand splint, no rehabilitation therapy order, and no mention of splinting in the care plan. Multiple observations by the surveyor over several days confirmed the resident was not provided with a palm guard/hand splint, and staff interviews revealed that neither nursing nor therapy staff were aware of the need for these interventions until after the surveyor's inquiry. The Director of Rehab stated that therapy screenings are not automatically performed for all admissions and that nursing is responsible for notifying therapy of new residents requiring services. As a result, the resident was not screened by therapy upon admission, and the recommendations from the previous facility were not reviewed or implemented. The resident and staff confirmed that the palm guard/hand splint was not provided until after the surveyor's observations, indicating a delay in the provision of necessary specialized rehabilitative services.