Failure to Care Plan Resident’s Refusal of Hand Splint
Penalty
Summary
The facility failed to develop and implement a comprehensive, person-centered care plan addressing a resident’s refusal to wear a prescribed right hand/wrist splint for contractures. The resident was admitted with diagnoses including stroke and right-side weakness, and orders dated 1/3/24 documented use of a splint/brace/device. The care plan initiated an intervention for a resting right hand splint on 2/19/24 for actual contractures and risk of further contractures related to decreased mobility and right spastic hemiplegia following stroke, but the care plan did not document that the resident refused to wear the splint. During interviews, a CNA reported never seeing the resident wear a splint, and an LPN stated the resident does not wear the splint and always refuses it, further confirming that the resident’s refusal had not been incorporated into the care plan. These observations and record reviews showed that the care plan was not updated to reflect the resident’s ongoing refusal of the splint.
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