Failure to Provide Ordered Restorative Nursing Services and Therapeutic Device
Penalty
Summary
The facility failed to provide restorative nursing services and a prescribed therapeutic device as ordered by the physician and recommended by rehabilitative therapy staff for one resident. The resident, who had a history of hemiplegia and hemiparesis following a stroke, was recommended to receive a restorative nursing program including bilateral lower extremity assisted active range of motion (AAROM) exercises and active range of motion (AROM) exercises for the left upper extremity. Additionally, the use of a left modified palm guard and specific positioning of the left upper extremity were ordered. These interventions were confirmed by physician orders and therapy discharge summaries. Despite these orders, the resident's plan of care did not incorporate the required restorative nursing needs. The resident reported not receiving restorative exercises since discharge from therapy and noted inconsistent application of the palm guard. Review of the clinical record revealed no documentation that the restorative nursing program or the application of the palm guard was provided as ordered. The Nursing Home Administrator was unable to provide evidence that these services were being delivered according to physician orders.