|§483.25(c) Mobility. |
§483.25(c)(1) The facility must ensure that a resident who enters the facility without limited range of motion does not experience reduction in range of motion unless the resident's clinical condition demonstrates that a reduction in range of motion is unavoidable; and
§483.25(c)(2) A resident with limited range of motion receives appropriate treatment and services to increase range of motion and/or to prevent further decrease in range of motion.
§483.25(c)(3) A resident with limited mobility receives appropriate services, equipment, and assistance to maintain or improve mobility with the maximum practicable independence unless a reduction in mobility is demonstrably unavoidable.
Based on clinical record review and staff interview, it was determined that the facility failed to consistently provide services planned to maintain mobility/range of motion for two of four sampled residents receiving restorative nursing services (Resident 26 and 44).
A review of Resident 26's clinical record revealed that the resident was admitted to the facility on January 9, 2020, with diagnoses that included Cerebral Vascular Accident and arthritis.
Resident 26 had a current physician order initially dated November 3, 2020, to receive a Restorative Nursing Program for ambulation with a rollator walker BID (twice a day), bed mobility BID, grooming daily and transfer QID (four times) daily.
A review of the provision of the restorative nursing programs provided to the resident from November 1, 2020, to January 01, 2021, revealed that on November 15, 2020, December 23, 2020, December 31, 2020, the resident received the planned RNP only once daily for ambulation. On November 15, 2020, RNP for bed mobility was provided only once and the RNP for grooming had not been provided. On December 23, and December 31, 2020 RNP for grooming was not completed.
A review of Resident 44's clinical record revealed that the resident was admitted to the facility on December 3, 2013, with diagnoses that included Arthritis.
Resident 44 had a current physician order dated April 3, 2020, for a RNP for ambulation with rolling walker daily, grooming daily, and transfer BID and bed mobility BID.
A review of the documented records of the provision of Resident 44's restorative nursing program from November 1, 2020 to January 01, 2021, indicated that on November 18, 2020, November 29, 2020, December 13, 2020, December 16, 2020, December 23, and December 31, 2020, the facility failed to provide the resident's RNP for grooming.
Interview with the Director of Nursing on January 29, 2021 at approximately 9:45 a.m. confirmed that the above residents' restorative nursing programs were not provided as ordered on the above dates.
28 Pa. Code: 211.5(f) Clinical records
28 Pa Code 211.12 (a)(c)(d)(5) Nursing services
| ||Plan of Correction - To be completed: 03/17/2021|
The facility recognizes that it must ensure that residents with limited range of motion will receive the appropriate treatment and services to increase range of motion or prevent further decrease in range of motion.
1.The facility recognizes that it cannot retroactively correct the deficiency as it relates to residents 26 and 44.
2.Going forward, residents with limited mobility will be evaluated and receive the appropriate services to maintain or improve mobility unless a reduction in mobility is demonstrably unavoidable.
3.CNA's have been re-educated on consistently providing services to the residents to maintain or improve mobility/range of motion.
4.A QA audit will be completed twice weekly x 3 months.
5.Conmpletion date 3/17/2021.