Failure to Provide Properly Fitting Wheelchair for Resident with MS
Penalty
Summary
The facility failed to ensure that a resident with multiple sclerosis had a properly fitting wheelchair that did not cause pain or discomfort. The resident, who was cognitively intact and dependent on staff for transfers, used a manual wheelchair that was too small and caused significant discomfort, particularly due to the resident's condition which resulted in one hip being higher than the other. The resident had purchased the wheelchair independently upon admission, without adequate guidance, and later reported that the chair was too short and painful to use. Despite the resident's complaints and the facility's policy requiring ongoing evaluation and accommodation of adaptive device needs, there was no documentation of an alternative plan or timely evaluation for a new wheelchair. The resident's care plan emphasized the need for physical comfort and maintenance of function within the limits of progressive MS, but the facility did not arrange for an occupational therapy evaluation or provide a suitable replacement wheelchair. Attempts to address the discomfort by providing a cushion were unsuccessful, as the cushion exacerbated the problem due to the chair's improper size. Interviews with facility staff, including the DON and Social Services Director, confirmed awareness of the resident's discomfort and the facility's responsibility to provide appropriate equipment. However, the Social Services Director had not successfully scheduled an occupational therapy evaluation, and the resident continued to lack a properly fitting wheelchair. The deficiency remained uncorrected from a previous survey, with no evidence of effective action taken to resolve the resident's ongoing discomfort.