Failure to Provide Required Range of Motion and Contracture Interventions
Penalty
Summary
The facility failed to provide appropriate range of motion (ROM) services and contracture interventions for multiple residents as required by their care plans and clinical assessments. For one resident with hemiplegia and moderate cognitive impairment, restorative services were ordered to be provided two to three times a week, but documentation showed services were only delivered on two occasions during the month, and the resident reported receiving restorative care only once in the past week. The Director of Nursing (DON) confirmed that restorative services had not been performed as indicated. Another resident, also with moderate cognitive impairment and physical impairments, was not assessed for the restorative program despite a family request, and there was no documentation that ROM exercises were provided, even though staff had been instructed to perform them during ADL care. Additionally, a resident with a contracted right hand and total dependence on staff for care had no formal interventions documented in the care plan or electronic health record for the contracture. Although an LPN reported occasionally using hand rolls, there were no consistent or formalized interventions in place, and the MDS coordinator acknowledged that such interventions should have been included in the care plan. These findings demonstrate a lack of adherence to facility policies and physician orders regarding the provision of ROM and contracture management services for residents with identified needs.