Failure to Provide and Document Required Hand Splints for Resident with Rheumatoid Arthritis
Penalty
Summary
The facility failed to provide hand splints for a resident diagnosed with rheumatoid arthritis, despite documented orders and care plan interventions indicating the need for bilateral hand splints as tolerated and for comfort. The resident reported that hand splints were previously applied by staff but went missing after a deep cleaning nearly a year prior, and were never replaced despite informing staff. Observations confirmed the resident's left fingers were closed inward, and the resident described ongoing weakness, particularly in the left hand, and the inability to keep the left fingers open without assistance. Interviews with nursing staff, restorative staff, and the Director of Nursing revealed that none had seen the resident with hand splints for an extended period, with some stating the splints had not been present for over a year. The facility's records, including the order summary and care plan, documented the need for splints and monitoring for their use and condition, but there was no documentation in the progress notes or ADL records regarding the application or presence of hand splints. The facility's policy required documentation and monitoring of such devices, which was not followed in this case.