Failure to Provide Routine Range of Motion (ROM) Care
Penalty
Summary
A deficiency was identified when staff failed to provide routine assistance with range of motion (ROM) exercises to a resident with left-sided weakness and a self-care deficit. The resident's care plan, which was updated to reflect fall risk and impaired vision, directed staff to follow physical and occupational therapy instructions and to provide ROM to the left upper extremity as ordered. Documentation and care sheets indicated that ROM was to be performed daily, with specific instructions posted in the resident's room for staff reference. Despite these directives, a review of task documentation over a one-month period showed that ROM was not performed on most days, with only three days showing partial completion. Interviews with staff revealed that ROM exercises were rarely completed, as staff prioritized other tasks such as feeding and showers. The resident confirmed that therapy had stopped and that staff were not performing the exercises, relying instead on a visitor to assist with ROM when present. Further interviews with nursing staff and the DON confirmed that ROM was not consistently completed as required by the care plan and facility policy. The facility's policy on activities of daily living emphasized maintaining residents' abilities but did not provide specific procedures for ROM, and staff were unaware of the lack of consistent ROM care until it was brought to their attention during the survey.