Failure to Provide Restorative ROM Program as Ordered
Penalty
Summary
A deficiency was identified when the facility failed to provide restorative range of motion (ROM) programs in accordance with physician orders for a resident with hemiplegia affecting the right dominant side, type two diabetes mellitus with diabetic neuropathy, morbid obesity, and other conditions. The resident's care plan required passive ROM to the right upper extremity in all planes once a day, six to seven days per week, for 15 minutes each session, with quarterly reassessment. The resident was cognitively intact, did not reject care, and required maximal assistance with minimal verbal cues. Review of restorative program delivery records showed that the program was not consistently provided as ordered, with documentation reflecting delivery only four to five times per week over several weeks, rather than the minimum six times per week specified in the care plan and physician order. The DON confirmed that the program was not offered at the required frequency, resulting in non-compliance with the resident's prescribed restorative program.