Failure to Provide Consistent Rehabilitative Nursing Care Due to Staffing Shortages
Penalty
Summary
The facility failed to provide consistent rehabilitative nursing care as required for a resident with hemiplegia and hemiparesis following a cerebrovascular event. The resident had physician orders for restorative nursing therapy for the upper extremities and the application of a right upper extremity splint for up to six hours daily, with skin checks before and after application. However, documentation showed that therapy was only conducted on 7 out of the last 30 days in July, and observation revealed the resident was not using the prescribed splint at the time of review. The resident, who is nonverbal, indicated through gestures that she does not like the splint and does not always receive therapy. Interviews with staff confirmed that the restorative nursing program (RNP) was not being performed daily or consistently as ordered. The restorative aide explained that when there is insufficient staffing, the RNP aide is reassigned to work as a nursing assistant, resulting in missed restorative care sessions. This failure to provide ordered rehabilitative care was attributed to staffing shortages, as confirmed by staff interviews and documentation review.