Failure to Provide Restorative Nursing Services for Range of Motion
Penalty
Summary
The facility failed to provide restorative nursing services to maintain or improve range of motion (ROM) for a resident with significant physical limitations. The resident, who had a history of stroke, quadriplegia, cerebral palsy, and traumatic brain injury, was observed with severely contracted hands and reported that staff did not assist him with exercises to improve his hand function. Although the resident had a physician's order for a left hand splint and a recommendation for a ROM program following discharge from occupational and physical therapy, he stated that he did not consistently wear the splint and had not received help from staff to work on his hands. Interviews with facility staff revealed that while therapy staff had recommended a restorative program and completed a referral to nursing, the facility did not have an established restorative program, nor did it employ a restorative nurse or restorative CNA. The Director of Nursing confirmed the absence of such a program, despite the facility's policy stating that residents should receive restorative nursing care as needed. Documentation showed that the resident's therapy had ended several months prior, and no restorative interventions were implemented by nursing staff to address his ongoing needs.