Failure to Provide Timely Rehabilitation Services Due to Staff Communication Breakdown
Penalty
Summary
A resident was admitted to the facility following knee surgery and arrived in the evening. Upon admission, the resident was placed in bed and instructed not to get out until assessed by physical therapy, despite the surgeon's recommendation for early ambulation to aid recovery. The resident requested assistance to use the lavatory but was told to use a bed pan or brief until a physical therapy assessment could be completed. The family inquired about when the resident would be seen by physical therapy and was informed that, due to it being the weekend, the assessment would not occur until Monday. Facility documentation and staff interviews revealed that the physical therapy department was short-staffed and had no therapist available on Saturday, resulting in a delay in assessment. The social worker was aware of the family's dissatisfaction and was unable to reach the physical therapy department or arrange a transfer to another facility due to weekend hours. The Director of Physical Therapy confirmed that the delay and the restriction on the resident's mobility were inappropriate, and clarified that nursing staff should have assessed the resident's ability to ambulate. A licensed nurse indicated a belief that only physical therapy could determine the appropriate level of care for ambulation, and the Nursing Home Administrator acknowledged a breakdown in communication regarding responsibilities between nursing and physical therapy staff.