Failure to Provide Timely Mobility Services and Equipment
Penalty
Summary
A resident with a history of hemiplegia and hemiparesis following a stroke, resulting in left-sided weakness, did not receive timely and appropriate services, equipment, or assistance to maintain or improve range of motion and mobility. The resident reported that she was supposed to receive a brace for her left leg, but it was significantly delayed. Clinical record review showed repeated documentation by a Certified Registered Nurse Practitioner (CRNP) and a physician requesting a physical therapy (PT) consult to evaluate the need for a lower left extremity (LLE) brace, but there was no evidence of current PT treatment orders or follow-through on these consult requests. The resident's care plan included interventions for limited physical mobility and referrals to PT and occupational therapy (OT) as needed, but these interventions were not implemented as required. Staff interviews revealed that the CRNP did not submit the necessary therapy request for a screen, which is the process used by therapy to identify outstanding evaluations. There was a lack of communication between the nurse practitioner and nursing staff regarding the ongoing provider request, resulting in the resident not receiving the needed evaluation and equipment in a timely manner.