Failure to Provide Prescribed Restorative Services Due to Staffing Issues
Penalty
Summary
The facility failed to provide restorative services as prescribed for residents referred to the restorative program by the therapy department. Nineteen residents were identified as receiving restorative services, and four of these had specific restorative exercise plans developed by therapy. However, these four residents were not receiving the services according to their restorative therapy plans. Observations and interviews revealed that residents were not receiving the required range of motion (ROM) exercises and other restorative interventions as ordered, with some residents reporting that they had not received services for weeks or could not recall the last time they received them. Documentation showed that these residents only received restorative therapy twice in the previous ten days, despite plans calling for three sessions per week. Staff interviews indicated that the restorative aide was frequently reassigned to other duties, resulting in restorative services not being delivered consistently. The restorative aide confirmed being pulled to the floor almost daily, and the Director of Nursing acknowledged that the restorative program was not functioning as intended. The physical therapist was aware that restorative services were not being provided as ordered due to staffing issues. Review of staffing sheets confirmed that the restorative aide was reassigned to other duties on seven out of twelve days reviewed. Residents affected by this deficiency included individuals with significant mobility limitations, such as incomplete quadriplegia, muscle weakness, and impaired range of motion. These residents required assistance with activities of daily living and had care plans specifying the need for restorative interventions to maintain or improve their functional status. Despite these documented needs and therapy recommendations, the facility did not ensure that restorative services were delivered as planned.