Failure to Provide and Assess Restorative ROM Services for Residents with Limited Mobility
Penalty
Summary
The facility failed to ensure that two residents with limited mobility received appropriate restorative services and assistance to maintain or improve their range of motion (ROM) as ordered. For one resident with severe cognitive impairment and multiple diagnoses including Alzheimer's disease, hemiplegia, and muscle weakness, the care plan required daily passive range of motion (PROM) exercises for both upper and lower extremities. However, restorative nursing logs showed inconsistent and often minimal completion of PROM, with several days where exercises were not performed at all. Staff interviews confirmed that ROM was only completed during morning care, and there was no evidence of regular review or assessment of the program's appropriateness. Another resident with multiple sclerosis, paraplegia, and a history of contractures had a care plan for a daily stretching program at bedtime. Documentation revealed that PROM was inconsistently performed, with several days missed and no prior tracking available before a certain date. The resident reported that ROM exercises were only done if specifically requested, and staff interviews indicated a lack of program review and assessment. The registered nurse acknowledged that the absence of regular assessments contributed to the failure to identify and address these deficiencies.