Failure to Maintain Restorative Program and Hand Contracture Interventions
Penalty
Summary
The facility failed to implement a restorative program to prevent the decline of residents' functional abilities, specifically for a resident with contractures of both hands. The resident had multiple diagnoses, including quadriplegia and contractures, and physician orders directed that rolled washcloths be applied to both hands twice daily. The care plan also included this intervention. However, observations revealed that the resident's hands were clenched in a tight-fisted position without the prescribed splints or washcloths in place. This absence was verified by nursing staff during the survey. Interviews with facility staff, including LPNs and the Therapy Director, confirmed that there was no restorative program in place to address range of motion exercises or to implement therapy recommendations after therapy services were discontinued. The Therapy Director acknowledged that residents who had received therapy services were at risk for functional decline due to the lack of restorative follow-up. The Assistant Director of Nursing also verified the absence of a restorative program and the failure to maintain the resident's hand splints as ordered.