Failure to Provide Consistent Range of Motion Services
Penalty
Summary
The facility failed to provide consistent and adequate range of motion (ROM) treatment and services to two residents with significant mobility limitations. One resident, admitted with hemiplegia affecting the left side and contractures in the left hand and both elbows, was observed multiple times without the prescribed right arm splint and left hand roll. Interviews with restorative staff confirmed that the resident was not receiving the required ROM exercises at the prescribed frequency, with documentation showing that both splint application and ROM exercises were only completed on a few days in April and May, rather than the six times per week as ordered in the care plan. Another resident, admitted with hemiplegia and hemiparesis following a stroke, was also not consistently provided with passive ROM (PROM) exercises as outlined in their care plan. Observations over several days showed the resident in bed with foot pads on, but no evidence of ROM activity during multiple shifts. Staff interviews revealed that PROM was not being provided at the required frequency due to staffing shortages, and the treatment administration record confirmed that PROM was only completed on a few days in April and May, rather than the three times per week specified in the care plan. The Director of Nursing acknowledged that both residents did not have consistent ROM completed, and staff interviews emphasized the importance of these interventions in maintaining mobility and preventing further contractures. The facility's own restorative program policy states the intent to help residents achieve and maintain their highest functional level, but the observed and documented care did not meet these standards for the two residents involved.