Medilodge Of Port Huron

F 0688 On 5/21/25 at 9:11 AM the Director of Nursing (DON) and Restorative Nurse (RN) A were interviewed and RN A said there was a break in the process, the therapy to restorative recommendation sheet was not Level of Harm - Minimal harm or brought to their attention to initiate the restorative program. RN A confirmed Resident R74 did not begin the potential for actual harm recommended restorative program and agreed Resident R74 should receive the restorative program. The DON said

the process was not followed and therapy should deliver the restorative recommendation to RN A to initiate Residents Affected - Few restorative services.

Review of the facility policy titled Restorative Nursing Programs revised 1/1/2022 revealed in part: The goal(s) of Restorative Nursing includes improving and/or maintaining independence in activities of daily living and mobility. A Restorative Nursing Program, when appropriate is based on the comprehensive assessment and resident. The following types of residents could benefit from a Restorative Program(s) but limited to: Contracture prevention and/or management. Areas that may indicate a referral to rehabilitation are warranted: End of therapy to continue goal achievement or maintenance and prevent decline. Restorative documentation requirements include Incorporated into the plan of care which is part of the clinical record.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 2 of 2 235421