Failure to Provide Ordered Restorative Nursing Services Seven Days a Week
Penalty
Summary
The facility failed to ensure that two residents received Restorative Nurse Assistant (RNA) services as ordered by their physicians, specifically the application of bilateral elbow splints seven days a week. Both residents had physician orders and care plans indicating the need for daily application of elbow splints to prevent contractures and maintain range of motion. However, a review of RNA task forms revealed that the splints were not applied every day as required, with several days missed for each resident during the review periods. One resident, with diagnoses including hypertension, dysphagia, and respiratory failure, was dependent on staff for activities of daily living and had a care plan and physician order for daily bilateral elbow splint application. The RNA task form showed that the splints were not applied on a daily basis as ordered. Interviews with staff confirmed that the services were not provided every day, and staff acknowledged the importance of consistent splint application to prevent contractures. The second resident, diagnosed with traumatic brain injury, dysphagia, and respiratory failure, was also dependent on staff and had similar orders and care plan requirements for daily splint application. The RNA task form for this resident also indicated missed days. Staff interviews confirmed the inconsistency in providing the ordered restorative care. Facility policies and job descriptions reviewed during the survey supported the expectation that restorative nursing care should be provided as ordered and in accordance with residents' care plans.