Failure to Provide Restorative Nursing Therapy for Resident with Severe ROM Impairment
Penalty
Summary
A resident with a history of hemiplegia, hemiparesis following cerebral infarction, and functional quadriplegia was admitted to the facility and was dependent on nursing staff for activities of daily living. Clinical records, including a comprehensive assessment, indicated the resident had impairments in range of motion (ROM) in both upper and lower extremities. A joint mobility screen documented severe impairment in the resident's right wrist, left hand, and right hand, with approximately 25% or less of full ROM. Despite these findings, the resident was not placed on a restorative nursing therapy program, which would have included passive range of motion (PROM) exercises. Both the Director of Rehab and the Assistant Director of Nursing confirmed that the resident should have been offered restorative nursing therapy services following the decline in ROM. The facility's policy stated that restorative nursing care should be provided as needed to promote optimal safety and independence, but this was not implemented for the resident in question.