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F0558
D

Failure to Provide Appropriate Wheelchair Limits Resident Independence

Winter Park, Florida Survey Completed on 07-10-2025

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 a resident, admitted with a history of wedge compression fracture, falls, muscle wasting, and requiring assistance with personal care, was not provided with an appropriate wheelchair to accommodate her needs and preferences. The resident was cognitively intact, able to make her needs known, and had no upper or lower range of motion limitations. Despite her ability to independently maneuver a standard wheelchair, she was given a transport wheelchair upon admission, which limited her independence and ability to move around her room or the hallway. The resident reported requesting a standard wheelchair multiple times but was told she could not have one, without explanation. Staff interviews revealed that the Therapy Director and DON were unaware that the resident had been using a transport wheelchair for daily use and that she desired a standard wheelchair. The facility's process for assigning wheelchairs relied on information from the State Agency transfer form and PT evaluation, but all staff had access to standard wheelchairs stored on site. The resident's care plan included interventions to encourage mobility but did not specify the use of a transport chair or reflect her preference for independent mobility. The DON acknowledged that a transport wheelchair was inappropriate for daily use by a resident capable of independent ambulation and that the resident did not receive the correct wheelchair until several months after admission.

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