Failure to Provide Ordered Rehabilitative Services
Penalty
Summary
A deficiency occurred when the facility failed to provide specialized rehabilitative services, specifically physical therapy (PT) and occupational therapy (OT), as ordered by a physician for a resident who was bed bound. The resident's medical record documented diagnoses including Chronic Obstructive Pulmonary Disease, Chronic Diastolic Congestive Heart Failure, Morbid Obesity, and musculoskeletal symptoms. The care plan identified impaired physical mobility, and the Minimum Data Set (MDS) indicated the resident required substantial to maximal assistance for mobility and that other mobility assessments were not attempted due to medical or safety concerns. Despite a physician's order for PT and OT evaluation and treatment, the resident did not receive these services. During interviews, the resident reported not having received physical therapy during the year and expressed a desire to get out of bed, stating that staff told him they could not assist him without therapy involvement. The Director of Therapy confirmed that the therapy department had not worked with the resident and was unaware of why the therapy order was missed. The facility administrator was unable to locate a policy regarding following physician orders. These findings demonstrate that the facility did not implement the physician's order for specialized rehabilitative services for the resident.