Failure to Provide Restorative Therapy and Splint Application for Residents with Limited ROM
Penalty
Summary
The facility failed to provide appropriate restorative therapy and services to two residents with limited range of motion (ROM), as recommended by occupational therapy and documented in care plans. One resident, a male with a history of diabetes, pituitary gland neoplasm, and bilateral hip replacements, was discharged from occupational therapy with a recommendation for restorative nursing exercises. Despite this, there was no documentation of restorative services being provided for two weeks following the therapy discharge. Interviews revealed confusion among staff regarding the referral process and responsibility for initiating restorative services, resulting in the resident not receiving the recommended exercises during this period. Another resident, a female with a history of cerebral infarction, hemiplegia, hemiparesis, and rheumatoid arthritis, was identified as needing a left upper extremity splint to prevent further contracture. Despite this, observations over several days showed that the resident was not wearing the splint, and staff interviews indicated a lack of clarity regarding who was responsible for applying the splint. The restorative plan of care did not reflect the need for the splint, and staff were unaware of the specific requirements for its use, leading to inconsistent application and documentation. Both cases demonstrate failures in communication and implementation of restorative care plans, resulting in residents not receiving necessary interventions to maintain or improve their range of motion. The lack of coordination between therapy, nursing, and restorative staff contributed to these deficiencies, as evidenced by missing documentation, unclear responsibilities, and inconsistent follow-through on recommended treatments and device use.