Failure to Provide Ordered Restorative ROM Services
Penalty
Summary
The deficiency involves the facility’s failure to provide restorative physical therapy services and devices as recommended by the therapy department for a resident with multiple complex medical conditions. The resident was admitted with non-active primary progressive multiple sclerosis, delusional disorder, unspecified tremors, uninhibited neurogenic bladder, and a nonrheumatic mitral valve disorder. The resident’s care plan, dated 12/13/25, documented that she required assistance with basic ADLs, including transfers, due to MS, and that her call light should be kept within reach. Despite these identified needs and the expectation for restorative services, the resident did not receive the restorative range of motion program that she believed she was supposed to have. During an observation on 01/05/26 at 6:10 p.m., the resident was seen lying in bed with her head positioned near her left shoulder and visible contractures of both hands. She stated she thought she was supposed to receive range of motion exercises from the restorative program, reported that she was not receiving them, and expressed that she would like to receive them. In a subsequent interview on 01/06/26 at 9:15 a.m., the Activity Director, who stated she was responsible for the restorative nursing program, confirmed that she did not offer range of motion or restorative nursing services to this resident. The surveyors determined that this failure to provide restorative services was likely to result in pain and decreased mobility, causing psychosocial harm and despair.
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