Failure to Provide Restorative Services for Resident with Contractures
Penalty
Summary
Staff failed to provide restorative nursing and therapy services as outlined in the care plan for a resident with Parkinson's disease and severe contractures. The resident's care plan specified the need for restorative interventions, including arm and leg exercises on both sides and the use of a stuffed animal in the hands to address contractures. However, observations over multiple days revealed that the resident's hands were severely contracted in a gripping position, arms were tight to the chest, and feet were pointed downward, with no adaptive devices or stuffed animals in place as required by the care plan. Interviews with multiple CNAs indicated a lack of awareness and implementation of the resident's ROM program. One CNA stated that ROM exercises should be performed by the bath aide as noted in the white binder, but confirmed she was not aware of any ROM program for the resident. Review of the white binder showed no documentation of ROM exercises for the resident. Additional CNAs reported significant difficulty in cleaning the resident's hands due to contractures and noted very limited arm mobility, with one CNA suggesting possible skin breakdown in the inner hands. These findings confirm that staff did not implement the planned interventions for contractures.