Failure to Provide Restorative Care and Proper Positioning for Residents with ROM Needs
Penalty
Summary
The facility failed to provide restorative care and proper positioning for multiple residents with documented needs for range of motion (ROM) and mobility support. One resident with multiple sclerosis, who was dependent on staff for transfers and wheelchair mobility and had limitations in lower extremity ROM, did not receive restorative care as outlined in her care plan. Observations showed her feet were left unsupported while seated in a Geri-chair at the dining table, contrary to facility policy and her care plan instructions. Staff interviews confirmed a lack of awareness regarding the need for foot support and acknowledged that restorative care had not been performed as required. Another resident with a history of cerebrovascular accident (CVA) and lower extremity ROM limitation was also not consistently provided with restorative care. Although her care plan specified daily active and passive ROM exercises, documentation revealed that restorative care was only provided sporadically over several months. Staff confirmed that the resident was not receiving the prescribed daily restorative care, and administrative staff acknowledged the deficiency in care delivery and documentation. A third resident with multiple sclerosis, who had no current ROM impairment but was prescribed upper extremity exercises with weights, did not receive the restorative care outlined in her care plan. The care area assessment for this resident triggered but lacked analysis, and staff interviews confirmed that restorative care was not being provided daily as required. Facility policies required maintenance and restorative services to maintain or improve residents' abilities, but these were not followed for the residents reviewed.