Failure to Provide Timely Restorative Nursing Services for Mobility
Penalty
Summary
A deficiency was identified when a resident with limited mobility and diagnoses including muscle weakness, COPD, and chronic systolic congestive heart failure did not receive appropriate restorative nursing services to maintain or improve range of motion (ROM) and mobility. The facility's policy required restorative care to promote optimal safety and independence, and the resident's physical therapy discharge summary specified the need for a Restorative Nursing Program (RNP) for bed mobility and active ROM. However, review of the resident's care plan revealed that only active ROM was included, and there was no RNP for bed mobility as recommended. Additionally, the ROM program was not initiated until several weeks after therapy discharge, and documentation showed it was marked as 'Not Applicable' on multiple shifts, indicating the interventions were not provided as required. During interviews, the resident expressed concerns about not receiving enough therapy to prepare for discharge home. The Director of Nursing confirmed that both restorative programs should have been started immediately after therapy discharge and that 'Not Applicable' was not an appropriate documentation response. These findings demonstrate that the facility failed to ensure the resident received timely and appropriate restorative services, equipment, and assistance to maintain or improve mobility, as required by facility policy and regulatory standards.