CMS Manual System - Louisiana Department of Health and Hospitals

The failures of the facility to provide appropriate care and services to improve
continence, manage indwelling catheters, and minimize negative outcome
places residents at risk for more than minimal harm. Therefore, Severity
Level 1 does not apply for this regulatory requirement.
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§483.25(e) Range of motion.
Based on the comprehensive assessment of a resident, the facility must ensure that
(see Tag F318 for intent, guidelines, procedures, and probes for §483.25(e))
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F317
§483.25(e)(1) A resident who enters the facility without a 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
SEE INTERPRERTIVE GUIDELINES AT TAG F318
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F318
(Rev. 66, Issued: 10-01-10, Effective: 10-01-10 Implementation: 10-01-10)
§483.25(e)(2) A resident with a limited range of motion receives appropriate
treatment and services to increase range of motion and/or to prevent further
decrease in range of motion
Intent §483.25(e)
The intent of this regulation is to ensure that the resident reaches and maintains his or her
highest level of range of motion and to prevent avoidable decline of range of motion.
Interpretive Guidelines §483.25(e)
―Range of motion (ROM)‖ is defined as the extent of movement of a joint.
The clinical condition that may demonstrate that a reduction in ROM is unavoidable is:
limbs or digits immobilized because of injury or surgical procedures (e.g., surgical
adhesions).
Adequate preventive care may include active ROM performed by the resident‘s passive
ROM performed by staff; active-assistive ROM exercise performed by the resident and
staff; and application of splints and braces, if necessary.