Failure to Provide Consistent Ambulation Services for Resident on Walk-to-Dine Program
Penalty
Summary
A deficiency occurred when the facility failed to ensure that a resident with limited range of motion consistently received appropriate restorative nursing services to maintain ambulation, as outlined in the facility's policy. The resident, who had diagnoses including functional quadriplegia, history of falls, altered mental status, and fibromyalgia, was dependent on staff for several activities of daily living and required moderate assistance with transfers and repositioning. Despite being identified for the walk-to-dine program, which was intended to help maintain mobility by assisting the resident to ambulate to the dining room, staff routinely transported the resident by wheelchair without offering ambulation assistance. Observations showed that staff did not offer to ambulate the resident to the dining room, instead wheeling her in a wheelchair. The resident reported that she was only assisted to walk to the dining room once in the past two weeks, despite a green card on her wheelchair indicating participation in the walk-to-dine program. The resident expressed concern about losing her ability to ambulate due to the lack of consistent participation in the program. The Kardex instructed staff to offer ambulation assistance for every meal, but the resident's care plan was not updated to reflect this intervention. Interviews with staff revealed confusion about the meaning of the green walking man symbol and uncertainty regarding which residents were on the walk-to-dine program. The director of rehabilitation confirmed that the program was intended to maintain residents' physical abilities and that staff should have been educated about the resident's participation. However, there was no clear documentation or communication in the electronic medical record to confirm that staff were informed about the resident's status in the program after discharge from physical therapy.