Failure to Provide Timely Physical Therapy Evaluations
Penalty
Summary
The facility failed to provide specialized rehabilitative services, specifically physical therapy (PT) evaluations, for six out of seven sampled residents who had physician orders for PT evaluation and treatment. Despite documented medical needs such as hemiplegia, hemiparesis, recent amputations, vertebral fractures, and other mobility-impairing conditions, these residents did not receive timely PT assessments upon admission. The absence of a licensed PT on staff led to delays, with the facility relying on agency PTs who were only available on an as-needed basis, rather than consistently present to perform required evaluations. Multiple interviews with staff, including the acting director of rehabilitation (a certified occupational therapy assistant), confirmed that PT evaluations were difficult to obtain due to the lack of an in-house PT. The COTA stated they could not perform PT evaluations and that agency PTs were only intermittently available. Residents and family members reported concerns, including one resident who did not receive assistance with prosthetic legs and another whose back brace was not properly applied for several days due to lack of PT involvement. These issues were corroborated by the Ombudsman and family interviews, which highlighted the residents' unmet rehabilitative needs and dissatisfaction with the care provided. Record reviews showed that all six residents had physician orders for PT evaluation and treatment, but these were not fulfilled in a timely manner. Facility policy required that specialized rehabilitative services be provided by qualified personnel upon physician order, but the lack of a consistent PT presence resulted in noncompliance with this policy. The deficiency placed residents at risk of a decline in mobility and failure to address their rehabilitative needs as ordered by their physicians.