| 71 |
FAITH HEALTHCARE CENTER |
425009 |
617 WEST MARION STREET |
FLORENCE |
SC |
29501 |
2017-06-14 |
318 |
D |
0 |
1 |
J20Y11 |
Based on observation, record review and interview, the facility failed to ensure that range or motion services were provided for 1 (Resident #110) of 3 residents reviewed in Stage 2 for range of motion. The findings included: Record review for Resident #110 of Restorative Nursing Policies and Procedures dated 12/01/14 revealed, Subject: Joint Mobility/Range of Motion (ROM) Program and Splinting - Initiating the Program Policy: Patients/residents will be assessed for joint mobility limitation upon admission, re-admission, quarterly, annually, and with significant changes .A restorative program will be implemented through the care plan to increase, maintain, or prevent deterioration of joint mobility and to maximize physical function when referral to therapy is not indicated .Orthotic, assistive, or prosthetic devices will be provided if indicated .Procedures: 2. The problems, goals, target dates and approaches are documented on the patients/residents care plan .Candidates: Appropriate candidates for the Nursing Restorative ROM (Range of motion) Program may include, but are not limited to, patients/residents with the following conditions: contractures, decreased AROM (active range of motion), Decreased PROM (passive range of motion) . Record review of the admission nurses note for Resident #110 dated 3/22/17 at 6:00 PM, revealed, .Body assessment completed . Bilat (bilateral) lower extremities contracted .resident requires total assistance and care with all needs . Record review of Care Plan for Resident #110 dated 03/22/17 revealed, Resident is limited in range of motion to R/T (related to) contractures of the upper and lower extremities .Goal Resident's joint contractures will be free from injury and skin breakdown Perform a contracture assessment .Staff to perform PROM (passive range of motion) during ADLs (activities of daily living)/care as tolerated . Record review of Minimal Data Set (MDS) for Resident #110 dated 03/28/17 revealed, Section G Functional Status indicates that the resident is dependent in all areas of care. On the following dates and times during observations, the Resident # 110 was found in her bed, with bilateral contractions to her legs, positioned on her back, no splints, and towel rolls in her hand: 04/11/17 at 8:40 AM, 10:17 AM, 11:03 AM, 12:27 AM, 1:32 AM, 2:29 AM, and 3:06 AM, 4:54 AM, and 5:17 AM. On 4/12/17 at 7:42 AM and 8:44 AM. On 04/12/17 she was up in her chair at 10:39 AM, 1:19 AM, and 2:40 PM, tilted to her left side with no support, splints, or other interventions for contractures. On 04/12/17 at 11:39 am during an interview with Occupational Therapy's Staff #127, when asked if residents get screened when they are admitted , to decide whether they need therapy, she confirmed that they are. When asked if there is a reason why someone would not be screened, she confirmed that sometimes, only a screen is appropriate and therapy will not pick them, up but they should be screened right away. When asked who decides when a resident may need a therapy evaluation, she stated, It is a multi-tier- decision. I have had nurses, therapists, or other coworkers ask for screenings. When asked if someone contracted, what interventions are normally recommended, or how would the process begin, she stated, Anyone that comes to this facility should be evaluated based on how they will be, here. You go through the same process with everyone. For contractures, you would do passive range of motion and try to find the most appropriate splint, then decide how long they should wear it, then DC (discontinue) the resident from therapy and they go to restorative (nursing). Then it is a nursing decision. When asked who provides the therapy recommendations if a splint is required or passive range of motion, she confirmed that nursing will provide those interventions after the therapy evaluation. When asked if there would be any situation where a resident with contractures would not receive some type of intervention, she stated, pain may be an issue, its situational . On 04/12/17 at 11:46 AM during an interview with Physical Therapy Assistant Staff # 123, when asked if Resident #110 has been evaluated by therapy, the stated, We screened off on her. We don't have a full-time OT (occupational therapist), so she is awaiting an eval (evaluation) on Thursday .When asked where this information is documented, he confirmed it should be in her chart . On 04/12/17 at 2:48 PM during an interview with Licensed Practical Nurse #66, when asked if there was anyone that she is taking care of today that receives range of motion from nursing, she stated, No, restorative does that. They (CNA's) may walk them and things like that. The CNA's aren't told to do it (ROM), they do get them up and do ADL's (activities of daily living). On 04/12/17 at 3:08 PM, during an interview with Restorative Aide Staff #99, when asked if Resident #110 was on restorative services such as range of motion, she confirmed that therapy have not given recommendations for her for any restorative services. |
2020-09-01 |