Failure to Consistently Provide Range of Motion and Splinting Care
Penalty
Summary
The facility failed to provide appropriate care and services to maintain or improve range of motion (ROM) for three residents with a history of stroke and left-sided paralysis, all of whom were dependent on staff for activities of daily living. Observations revealed that one resident had a splint positioned incorrectly on their hand, with the foam meant to separate the palm and fingers placed on top of the hand instead of in the palm. Documentation review showed that the daily ROM programs for all three residents were not consistently completed, with 14 days in the month lacking signatures to indicate the programs had been carried out. Additionally, there were no directives or information regarding the use of the splint in the care plan for one resident. Interviews with staff indicated that the restorative nursing programs were often missed due to staffing shortages, with the Restorative Nursing Assistant (RNA) being pulled to work on the floor and no coverage provided during their days off or vacation. One resident's collateral contact reported that the resident's hand splint was frequently dirty and the palm had an odor, suggesting inadequate care. The Director of Nursing acknowledged awareness of the inconsistent completion of ROM programs, attributing it to insufficient staffing.