Failure to Provide Timely Physical Therapy Evaluation for Knee Osteoarthritis
Penalty
Summary
A deficiency occurred when the facility failed to provide specialized rehabilitative services as required for a resident with bilateral primary osteoarthritis of the knees. The resident was referred by an orthopedic physician for a physical therapy (PT) evaluation and treatment to address knee pain and stiffness, with a specific order for PT to be conducted 2-3 times per week for 6-8 weeks. However, there was no evidence that a PT evaluation was completed following the physician's referral. The resident continued to experience pain that interfered with sleep and daily activities, as documented in the Minimum Data Set (MDS) assessment. Four months after the initial referral, a new request for a rehabilitation screen was made due to increased knee pain, and a subsequent physician's order again called for a PT evaluation. Despite these orders, the resident was only approached once for a PT evaluation, which was not completed due to the resident's temporary illness. Occupational therapy (OT) was conducted instead, but the OT evaluation did not assess knee pain or stiffness as specified in the PT order. There was no documentation that the resident was re-approached for PT after recovering from the illness. Interviews with rehabilitation staff confirmed that the PT evaluation was not completed as ordered and that the staff was unaware of the initial referral and order for PT services.