Failure to Provide PROM to Prevent Decline in Range of Motion
Penalty
Summary
The facility failed to provide appropriate treatment to prevent further decrease in range of motion (ROM) for a resident with a history of hemiplegia and hemiparesis following a cerebral infarction affecting the left side. The resident, who was severely cognitively impaired and dependent on staff for activities of daily living, was not given passive range of motion (PROM) exercises to the left arm as required by the care plan and the facility's policies. Record reviews and staff interviews confirmed that PROM was only provided to the resident's right arm, right leg, and left leg, omitting the left arm despite documented impaired mobility in the left shoulder. During an observation, when PROM was finally provided to the resident's left shoulder, the resident exhibited pain and joint stiffness, indicating a decline in ROM. The care plan specifically identified the risk for decline in ROM and included interventions for PROM to both arms and legs, but these interventions were not implemented for the left arm. The facility's own policies required that residents with limited ROM receive appropriate treatment to prevent further decline, which was not followed in this case.