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F0826
D

Rehabilitative Services Provided Without Physician Order

Barstow, California Survey Completed on 06-05-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure that specialized rehabilitative services were provided in accordance with federal regulations for one of two sampled residents. A resident who was readmitted with acute pulmonary edema and muscle weakness received both physical therapy (PT) and occupational therapy (OT) services for 25 days without a physician's order. Observations confirmed that the resident participated in PT and OT sessions, including sitting to standing transfers and arm exercises, under the guidance of therapy assistants. A review of the resident's clinical records revealed no documented physician's order for PT or OT treatment, nor any evidence that a physician had been notified about these services. During interviews, the Director of Rehab confirmed the ongoing therapy services, and the Director of Nurses stated unawareness of the regulatory requirement for a physician's order for such services. The facility did not have a formal policy or procedure to ensure physician oversight for rehabilitative treatments.

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