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F0688
D

Failure to Provide Physician-Recommended TLSO Brace

Bedford, Pennsylvania Survey Completed on 07-02-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

A resident with cognitive impairment and a history of a back fracture was assessed as requiring a TLSO brace following a hospital discharge. The hospital discharge records specified the need for the brace, and this recommendation was documented in the resident's clinical records. Despite this, the facility was unable to obtain the brace from one medical supplier, and another supplier could not provide it in a timely manner. The physical therapy department was tasked with obtaining the brace, but was ultimately told not to purchase it. The resident's daughter expressed a desire for the resident to be seen by a brain and spine specialist to obtain the brace, but this did not occur. As a result, the resident never received the prescribed TLSO brace. The Director of Therapy confirmed that she could have purchased the correct brace but was instructed not to do so. The absence of the brace led to a delay in physical therapy for several months, as the resident did not have the necessary support for therapy to proceed.

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