Failure to Provide Restorative Nursing Services for Residents with Limited Range of Motion
Penalty
Summary
The facility failed to provide appropriate treatment and services to maintain or improve range of motion (ROM) and mobility for two residents with limited ROM and restorative nursing needs. One resident, with a history of stroke, vascular dementia, and bilateral contractures, was observed in a wheelchair with poor positioning and lacked head support. Staff interviews revealed that the resident was dependent on staff for care and that no exercises or stretches were being performed, despite occupational therapy recommendations for bilateral ROM/stretching and splint application. The resident's treatment record included instructions for hand splint use but did not include the recommended ROM and stretching interventions. Another resident with a traumatic brain injury and contractures had care plans for passive and active assist ROM, as well as splint and brace use, with goals to prevent worsening of contractures. However, record review showed that these restorative programs were not being implemented. Staff interviews confirmed that the facility did not have an active restorative program due to staffing shortages, and the one staff member with restorative training was not being utilized in that role. This deficiency was noted as a repeat from a previous survey.