A decline in a resident’s range of motion (ROM) or mobility may result in a citation under F688 when the facility fails to demonstrate that appropriate assessments, interventions, and services were provided to prevent an avoidable decline. Changes identified through the Minimum Data Set (MDS), including a decline in functional range of motion, may prompt surveyors to further investigate whether the facility provided necessary care and services.
For residents admitted without a limited ROM, surveyors will evaluate whether the facility provided services and/or treatment to prevent reduction in ROM? For residents admitted with a limited ROM and/or mobility, surveyors will evaluate whether appropriate treatment, services, and equipment were provided to improve or maintain function and prevent further avoidable decline. These interventions must be based on the comprehensive assessment, person-centered care plan, resident preferences, and professional standards of practice.
For a decline to be considered unavoidable, documentation must reflect the attempts made by the facility to implement the care plan and revise interventions to address the changing needs of the resident.
The Long-Term Care Survey Process instructs surveyors to ask the resident and/or resident representative the following:
Facilities should routinely review changes in ROM and mobility, ensure interventions are consistently implemented, and maintain documentation demonstrating efforts to prevent avoidable declines. Refer to the Positioning, Mobility & Range of Motion critical element pathway for additional insight into the surveyor’s investigative process.