Failure to Provide Appropriately Fitting Wheelchair for Resident
Penalty
Summary
A deficiency was identified when the facility failed to assist a resident with finding an appropriately fitting wheelchair. The resident, who has diagnoses including lack of coordination, spinal stenosis with neurogenic claudication, morbid obesity, and osteoporosis, was previously using an electric wheelchair that was removed due to safety concerns and mechanical issues. She was transitioned to a manual wheelchair, which she found difficult to self-propel due to her feet not reaching the floor, resulting in loss of independence and physical discomfort, including bruising and skin breakdown from contact with the wheelchair. Observations and interviews revealed that the resident had to scoot forward in the seat to touch the floor with her toes, which staff discouraged for safety reasons. She reported using the wall rails to pull herself along and sometimes propelled herself backward, which caused shoulder soreness. The manual wheelchair provided was a 17-inch height model, and both the Rehabilitation Director and Physical Therapy Assistant acknowledged that it did not fit her properly, with her feet being several inches from the floor. Despite these issues, facility staff stated that no lower wheelchair was available and did not provide documentation of efforts to find a more suitable option. Physical therapy notes documented ongoing problems with wheelchair mobility, discomfort, and attempts to modify the wheelchair with a lower profile cushion, which only partially addressed the issue. The care plans indicated that the manual wheelchair was considered to meet her needs, but the resident continued to experience pain and difficulty with mobility. No evidence was provided to show that alternative wheelchair options were explored or that the resident was properly fitted for her current wheelchair.