Failure to Honor Resident Choice in Continuation of Therapy Services
Penalty
Summary
A resident admitted for orthopedic aftercare with multiple comorbidities, including severe osteoporosis, depression, chronic pain, muscle weakness, and difficulty walking, was found to have been denied the right to make choices regarding the continuation of specialized rehabilitative services. Despite being cognitively intact and expressing a clear desire to continue therapy to meet personal mobility goals, the resident's care plan did not reflect this preference. The resident reported confusion about the discontinuation of therapy services and stated that therapy sessions were only missed due to illness. The resident also indicated a lack of communication regarding therapy options, insurance coverage, and care plan meetings, and did not recall any discussions with the insurance company or staff about the continuation of therapy. Interviews with facility staff, including the case manager and a panel of leadership, confirmed that the resident was eligible for continued therapy services and that insurance coverage was still active. However, a breakdown in communication among staff resulted in the resident not receiving the requested therapy services. Facility policies require that residents be informed of changes to their care plan and be allowed to make informed choices about their treatment, but these procedures were not followed in this case.