Failure to Provide Ordered Occupational Therapy Services Due to Staffing Shortages
Penalty
Summary
A resident was admitted with diagnoses including cellulitis, kidney disease, mood disorder, and diabetes, and was referred from the hospital for a skilled rehabilitation stay specifically for wound care and therapy services, including physical and occupational therapy. Physician orders were in place for physical, occupational, and speech therapy evaluations and treatment. The Minimum Data Set assessment indicated the resident was cognitively intact but required substantial to maximum assistance with activities of daily living such as toileting, oral hygiene, bathing, dressing, and personal hygiene. Despite these orders and the resident's needs, the facility failed to provide occupational therapy services as required. The Therapy Director confirmed that while physical therapy was initiated, occupational therapy was not provided due to a lack of available occupational therapists. The facility only had staff for skilled evaluations and was unable to start occupational therapy until a new therapist was hired, which did not occur before the resident was discharged. Interviews with facility staff and the resident's family confirmed that the ordered therapy services were not delivered as promised, and staffing shortages were cited as the reason for this failure.