Failure to Identify and Treat Resident's Hand Contracture
Penalty
Summary
A resident with a diagnosis of corticobasal degeneration, cervicalgia, and essential tremor was admitted with a known left-hand contracture, as communicated during the admission report from the discharging facility. The resident exhibited functional limitations in range of motion on both sides of the body, used a wheelchair for ambulation, and required substantial to maximum assistance with activities of daily living. Observations revealed the resident's left hand was contracted, with fingers rigidly straight and the thumb pressed against the fingers, causing pain when manipulated. The resident reported that staff were not working with the hand to address the contracture. A review of the resident's medical record and care plan showed no documentation of the left-hand contracture or any active treatment to prevent its worsening. Interviews with facility staff, including an RN and the DON, confirmed that the contracture was known upon admission but was not identified in the care plan, and no interventions or therapy were in place to address the limited range of motion. The deficiency was identified based on the lack of assessment, documentation, and intervention for the resident's contracture.