Failure to Provide Requested Massage Therapy for Resident with Muscular Dystrophy
Penalty
Summary
The facility failed to ensure that specialized rehabilitative services, specifically massage therapy, were provided as required for a resident diagnosed with muscular dystrophy and major depressive disorder. The resident, who was cognitively intact and had limitations in range of motion in both upper extremities, repeatedly expressed his desire for massage therapy to address discomfort and pain. He communicated this need to staff and during a Resident Council meeting, and it was noted in progress notes that he had previously benefited from massage therapy. Despite a progress note indicating a referral to Physical Therapy for ultrasound and massage therapy, there was no corresponding physician order for physical therapy, and the resident was not evaluated for massage therapy until several weeks after his initial request. The care plan for the resident addressed pain management but did not include interventions related to massage therapy or range of motion relief. Staff interviews revealed confusion regarding responsibility for providing massage therapy, with the DON indicating Occupational Therapy was handling it, while the Director of Therapy confirmed the resident had not been evaluated for massage therapy until prompted by the survey. Additionally, the resident's request for transportation to receive massage therapy at the VA hospital was not facilitated, and his inquiries were not consistently communicated among staff. The lack of timely assessment and provision of the requested rehabilitative service resulted in the resident not receiving massage therapy as required.