Failure to Provide Range of Motion Services and Splint for Resident with Limited Mobility
Penalty
Summary
A resident with a history of hemiplegia and hemiparesis following a cerebral infarction, resulting in limited range of motion on the left side, did not receive appropriate services to prevent further decline in mobility. The resident expressed that his left hand could not open and requested to try a splint to improve function. Observations over several days confirmed that the resident did not have a splint in place and reported that staff were not performing range of motion exercises with him. The care plan indicated the resident was to wear a left hand brace daily, and an occupational therapy discharge summary documented that a splint had been ordered, with plans for OT to assess fit and provide education once delivered. Interviews with facility staff revealed that the order for the splint may not have been placed, and there was confusion regarding its status. The Business Office Manager was unsure if the order had been submitted, and the Executive Director later confirmed the order had not gone through. Additionally, the facility did not have restorative aides at the time, and the resident was not on a restorative program, which would typically be implemented after therapy discharge. The facility's policy required staff to assist residents with range of motion exercises and use of assistive devices, but these interventions were not provided to the resident as outlined.