Failure to Provide Range of Motion Services for Resident with Hemiplegia
Penalty
Summary
The facility failed to provide appropriate range of motion (ROM) services to a resident with hemiplegia and hemiparesis following a stroke, resulting in a partially contracted right hand. The resident's medical record documented the need for assistance with activities of daily living due to hemiplegia and generalized weakness, but the care plan lacked specific interventions to prevent contractures. Although the care plan instructed staff to monitor and report signs of immobility, it did not include any restorative or splint/brace therapy interventions. The resident reported not receiving ROM exercises or restorative services for his right hand, and his splint was out of reach, requiring staff assistance to apply it. Interviews with facility staff revealed that there was no active restorative program, and restorative aides were not available. Nursing staff were unaware of the resident's need for the hand splint, and the care plan did not address contracture prevention. The therapy consultant confirmed the resident's hand did not open fully and that he was educated on splint use, but the facility did not ensure consistent application or ROM services. The facility's own policy required restorative nursing care as needed, but this was not provided to the resident.