Failure to Provide Ordered Range of Motion and Splinting Interventions
Penalty
Summary
The facility failed to provide appropriate treatment and services to prevent a decline in range of motion for a resident with a right hand/wrist contracture and a history of hemiplegia and hemiparesis following a stroke. The resident was dependent on staff for activities of daily living and had severely impaired cognitive skills, making them rarely or never understood. The care plan and physician's orders specified that passive range of motion (PROM) and splint/brace application should be performed, with detailed instructions for timing and monitoring. However, observations revealed that the resident did not have a splint in place, and staff interviews indicated a lack of awareness or implementation of the splinting intervention. The resident was noted to experience significant pain with hand movement, and there was no evidence that PROM or splint/brace application had been provided as ordered. Review of documentation, including the Treatment Administration Record (TAR), showed no record of PROM or splint application for the resident during the specified period. Staff interviews confirmed that the interventions were not being carried out, and the Director of Nursing verified the absence of documentation for these required treatments. The facility's failure to follow the care plan and physician's orders resulted in a lack of appropriate care to maintain or improve the resident's range of motion.