Failure to Provide Restorative Nursing Services for ADL Maintenance
Penalty
Summary
The facility failed to provide restorative nursing services, specifically a restorative stretching program, for a resident who was identified as needing such interventions to maintain activities of daily living. The resident was cognitively impaired and required substantial to maximum assistance with bed mobility and transfers. Documentation indicated a referral for a stretching program for the resident's left lower extremity, with specific instructions to straighten the leg while in a chair and hold the stretch for a set duration, to be repeated up to five times or to the resident's maximum tolerance. Interviews with facility staff revealed inconsistencies and a lack of awareness regarding the implementation of the restorative program. The DON stated that nursing assistants were responsible for the restorative program, overseen by the charge nurse, while a registered nurse reported that there was no restorative nursing program in place. The rehab director confirmed a referral had been made, but nursing assistants described only basic care for the resident's left arm, such as washing, drying, and applying a splint, with no mention of the prescribed leg stretching program. The corporate regional nurse was unable to provide documentation of the restorative program for the resident's left lower leg.