Failure to Provide Timely Rehabilitative Services per Physician Orders
Penalty
Summary
The facility failed to provide specialized rehabilitative services as required by physician orders for one resident who was reviewed for position and mobility needs. The resident, who had a diagnosis of a brain bleed and severe right-sided weakness, was admitted with moderate cognitive impairment and required significant assistance with activities of daily living. Despite a physician's order for physical, occupational, and speech therapy evaluation and treatment, there was no documentation that the resident was evaluated or treated by the therapy department. The facility's policy required therapy evaluations to occur within 48 hours of receiving a physician's order, but this was not followed. Observations and interviews revealed that the resident did not receive any therapy or exercise program and expressed concerns about not being able to improve mobility. Staff interviews indicated a misunderstanding regarding insurance pre-authorization requirements, which led to a delay in therapy evaluation. The business office confirmed that pre-authorization was not needed and that the resident was eligible for therapy evaluation since admission, but the therapy department did not act on this information, resulting in the resident not receiving the ordered rehabilitative services.