F0688

D

Failure to Provide ROM Interventions and Therapeutic Devices for Contracture

Oklahoma City, Oklahoma Survey Completed on 02-18-2026

Penalty

Fine: $50,116

Summary

The facility failed to provide range of motion (ROM) exercises and therapeutic devices to maintain or improve mobility for a resident with a left-hand contracture and left-sided weakness. On observation, the resident’s left hand was contracted and completely closed into a fist, with no therapeutic devices in place, and the left arm could not be raised above shoulder height. The resident reported having no use of the left hand and being unable to raise the left arm above the shoulders, and stated that no therapeutic devices or therapies were being used to maintain or improve function. The facility’s Restorative Nursing Services policy stated that residents would receive restorative nursing care as needed to promote optimal safety and independence.

Record review showed the resident was admitted with renal failure and heart failure and had a physician’s note documenting left-sided weakness, but the admission assessment did not identify upper extremity impairment or a left-hand contracture, despite the resident being cognitively intact with a BIMS score of 14. Multiple staff interviews confirmed that the resident was not on restorative services, had no orders for therapeutic devices for the left-hand contracture, and was not receiving ROM exercises. The DON stated that residents with limited ROM or contractures should be admitted to therapy or the restorative program and acknowledged that this resident had not received restorative assistance since admission, despite needing interventions such as a rolled-up washcloth in the hand and passive ROM exercises.