Failure to Provide Restorative Services and Assessments for Residents with Limited Mobility
Penalty
Summary
The facility failed to provide appropriate care and restorative services to maintain or improve range of motion (ROM) and mobility for several residents with physical limitations. One resident with a history of cerebral infarction and right-sided hemiplegia was observed with a contracted right arm and tightly closed fist, without any splint or device in place. Staff interviews confirmed that the resident was admitted with a contracted hand and had not been provided with a splint until occupational therapy was recently initiated, despite the last restorative assessment being over a year prior. The resident's family expressed concerns about the lack of exercises or therapy and the resident being in bed most of the time. The facility did not have a formal restorative program, and assessments were only conducted through the MDS process. Additionally, three other residents with documented hemiparesis and contractures were observed without evidence of regular restorative assessments or consistent provision of restorative services. Staff interviews indicated that restorative assessments should be completed quarterly and that services such as passive ROM should be provided every shift. However, records showed gaps in restorative minutes provided and missing assessments for the year. The facility's own policy stated that all residents would receive maintenance nursing services, but this was not consistently implemented for residents with physical limitations.