Health inspection·August 30, 2024

F 0688 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to apply a splint to Resident 1 ' s right hand as ordered by a physician. This failure had the potential to worsen Resident 1 ' s wrist drop (a medical condition that prevents the wrist and fingers from extending fully). Findings: Resident 1 was admitted to the facility on [DATE] with diagnoses that included right wrist drop. On 8/14/24 at 2:40 P.M. an observation and interview were conducted with Resident 1 in her room. Resident 1 ' s right wrist was in a downward position and she was not wearing a splint (a device that positions a part of the body). Resident 1 stated, I don ' t have full use of my right hand. No one put my splint on me today, they often don ' t. On 8/14/24 at 3:30 P.M. an interview was conducted with the Director of Nursing (DON) who stated Resident 1 had a provider order for daily application of a splint to her right wrist except while exercising or showering. On 8/14/24 at 4:20 P.M. a concurrent observation was conducted with the DON of Resident 1 in her bed. Resident 1 was not wearing a splint on her right wrist, was not exercising or showering. The DON stated she would have to check the documentation of the Restorative Nursing Assistant (RNA, a staff member who helps restore and maintain a patient ' s highest level of function). On 8/19/24 at 3:33 P.M. a concurrent review with the DON via telephone of the RNA documentation was conducted. The document indicated range of motion exercises were provided 10 days of 26 possible days. The DON stated Resident 1 did not receive daily RNA interventions as ordered. On 8/20/24 at 3:25 P.M. an interview was conducted with the DON regarding documentation received dated 8/14/24, the date of the joint observation of Resident 1 without her splint on. The RNA document indicated, Wrist splint applied for RUE (right upper extremity) QD (every day) 7x/week (seven times per week), on at all times except during shower and exercise. The DON stated during the joint observation Resident 1 was not wearing a splint, and was not exercising or showering. A review of the facility policy entitled Restorative Nursing Program Guidelines revised September 19, 2019 indicated, Restorative nursing . includes nursing interventions that promote a patient ' s Page 1 of 2 055685 055685 08/30/2024 Brighton Place Spring Valley 9009 Campo Road Spring Valley, CA 91977

F 0688 ability to attain, and maintain his/ her optimal functional potential. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 055685 Page 2 of 2