Failure to Provide Ordered Passive Range of Motion (PROM) Exercises
Penalty
Summary
A resident with limited range of motion (ROM) and impairment on one side of the upper and lower extremities did not receive physician-ordered passive range of motion (PROM) exercises for two months. The resident was admitted with a mild cognitive impairment and required substantial to maximal assistance with personal hygiene. Physician orders and the care plan specified that the resident should receive active and passive ROM exercises to both upper and lower extremities three times per week for three months to maintain their current level of function and prevent contractures. However, progress notes indicated that the resident did not receive or refuse PROM exercises to the right extremity during this period. During interviews, the resident reported feeling weak and stated they had not received rehabilitation services. The restorative nursing aide (RNA) confirmed that PROM exercises were not performed on the right hand, citing the resident's inability to raise the hand, despite being aware of the physician's orders. The RNA also stated that the resident never refused the exercises. Facility policy required that residents with limited ROM receive treatment and services to increase or prevent further decrease in ROM, but this was not followed for this resident.