Failure to Provide Consistent Restorative Therapy as Recommended
Penalty
Summary
A resident under the age of 65 with diagnoses including hemiplegia, hemiparesis, major depressive disorder, and type 2 diabetes mellitus did not consistently receive restorative therapy services as recommended by the physical therapy department. The resident was cognitively intact and required varying levels of assistance with activities of daily living. Physical therapy discharge notes recommended a restorative ambulation program five times per week for six weeks to maintain the resident's current level of function, with an excellent prognosis if staff support was consistent. However, restorative nursing notes showed the resident only received therapy on 13 out of 22 possible occasions during the review period. Interviews with the restorative nursing aide (RNA) and the director of nursing (DON) revealed that the RNA was frequently pulled from providing restorative therapy to assist with other duties, such as accompanying residents to outside appointments and working the floor. The RNA confirmed he was unable to provide restorative services according to the resident's plan, and the DON was unaware of the specific frequency required for the resident's restorative program. Both acknowledged that the resident did not receive restorative services as scheduled, resulting in a failure to follow the physical therapy recommendations.