Failure to Provide Ordered Physical Therapy Services
Penalty
Summary
A deficiency occurred when a resident with multiple medical conditions, including polyneuropathy, generalized osteoarthritis, heart failure, obesity, and low back pain, did not receive physical therapy services as ordered by the physician. The physician's order specified that the resident should receive physical therapy five times a week for four weeks, with treatments including gait training, manual therapy, and wheelchair mobility training. However, documentation showed that during one week, the resident only received three physical therapy sessions instead of the prescribed five. The resident expressed awareness of not receiving therapy as frequently as expected and reported a desire to regain the ability to walk in order to leave the facility. The Rehab Director confirmed that the resident was scheduled to receive therapy five times a week, but missed sessions occurred due to a scheduling error and a staff absence, with no documentation of services provided on those days. The facility's policies require care and services to be provided in accordance with physician orders and for comprehensive care plans to be developed and implemented to meet residents' needs. The Assistant Director of Nursing acknowledged the importance of therapy in maintaining the resident's functional ability. The failure to provide therapy as ordered was confirmed through record review and staff interviews.