Failure to Provide Ordered Restorative Nursing Services
Penalty
Summary
A deficiency was identified when a resident with multiple fractures of the pelvis, orthopedic aftercare, and heart failure did not receive Restorative Nursing Assistance (RNA) services as ordered by the physician. The resident's Minimum Data Set indicated intact cognitive skills and independence in all activities of daily living. Physician orders specified that the resident was to receive active assisted and active range of motion exercises to the right lower extremity and bilateral upper extremities every day, three times a week or as tolerated. Record review and staff interviews confirmed that the resident did not receive the ordered RNA services during the months reviewed. The Registered Nurse acknowledged that the restorative services were not provided as ordered, and the Director of Nursing stated that all residents should receive RNA services as ordered, with refusals documented and addressed. The facility's policy required that residents receive restorative nursing services as needed to promote optimal safety and independence.