Failure to Provide Orthotic Devices and Services for Residents with Limited ROM
Penalty
Summary
The facility failed to assess and provide necessary orthotic devices and services to residents with limited range of motion (ROM), resulting in a deficiency. Two residents with significant medical histories, including hemiplegia and hemiparesis following cerebral infarction, were observed to have functional limitations in ROM affecting their upper and lower extremities. Both residents were cognitively intact and expressed difficulty in moving their affected limbs, with one resident specifically requesting a device to support her weak arm and hand, and the other requesting a splint for proper positioning and to prevent further decline. Despite these requests and visible signs of weakness and contracture, neither resident had been provided with the appropriate orthotic devices at the time of observation. Interviews and record reviews revealed that the Director of Nursing was made aware of the residents' conditions and stated that she would request occupational therapy assessments. Occupational therapy screenings subsequently confirmed the need for devices such as a palm protector and a resting hand splint to prevent further contracture and weakness. However, prior to these assessments and recommendations, the facility had not implemented measures to provide the necessary orthotic support, nor had staff reported the residents' conditions in a timely manner to therapy services, resulting in a lack of appropriate care to maintain or improve the residents' ROM and mobility.