Failure to Provide Restorative Care and Splint Application
Penalty
Summary
The facility failed to provide adequate restorative care for a resident in a persistent vegetative state who was dependent on staff for all care and had documented arm and foot contractures. The resident's care plan included the use of heel boots and positioning with stuffed animals to maintain skin integrity, but lacked interventions for wrist braces. Observations revealed that the resident was not wearing required boots or hand braces, and her limbs were positioned in a way that could contribute to further contractures. Staff interviews confirmed that wrist splints were missing or broken, and that there was no active restorative program in place. Certified Nurse Aides (CNAs) reported not performing range of motion (ROM) exercises or restorative programs, and therapy staff found the splints unused and stored away. Further interviews with nursing and administrative staff revealed that the facility had not had a restorative program for an extended period, and no restorative assessments or evaluations had been completed due to lack of trained staff. The facility's own guidelines required residents to be screened or evaluated for restorative programs when needed, but this was not done for the resident in question. The lack of restorative care and failure to apply necessary splints placed the resident at risk for increased pain and contractures.