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F0628
D

Failure to Provide Medically Necessary Walker at Discharge

Rockville, Connecticut Survey Completed on 04-29-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

A deficiency occurred when the facility failed to provide a medically necessary walker for a resident upon discharge. The resident, who had diagnoses including acute respiratory failure and congestive heart failure, was identified in the care plan as having potential for discharge with interventions to evaluate the need for assistive devices. Both occupational and physical therapy discharge summaries recommended a walker for safe functional mobility. The physician's discharge note also listed a walker as required durable medical equipment. However, the social services documentation did not indicate that a walker was ordered for the resident at discharge. Post-discharge assessments revealed problems with both oxygen and the walker, with no documented follow-up or resolution. An interview with a family member confirmed that the resident was discharged without a walker or wheelchair and experienced two falls at home before a walker was purchased independently. Facility policy required that discharge care plans address equipment needs and document referrals, but there was no evidence that a walker was provided or ordered for the resident at discharge.

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