ALF Residents with contractures

When a person suffers from diseases such as osteoarthritis, Parkinson’s disease, and inflammatory diseases like rheumatoid arthritis they will often have contractures. Contractures are the result of constriction in the connective tissues of your body (muscles, tendons, ligaments, and skin). This can cause the person to have difficulty moving hands, stretching legs, straightening fingers, or even extending other parts of their body. Likely you will have residents who are dealing with these ailments. The good news is you are allowed to manage their care if you abide by the following regulation provided by CCLD:


(a) Except as specified in Section 87611(a), the licensee shall be permitted to accept or retain a resident who has contractures under the following circumstances:

(1) If the contractures do not severely affect the functional ability and the resident is able to care for the contractures by him/herself. OR

(2) If the contractures do not severely affect the functional ability and care and/or supervision is provided by an appropriately skilled professional.

(b), the licensee shall be responsible for the following:

(1) Ensuring that range of motion or another exercise (s), if prescribed by the physician or physical therapist, is performed by an appropriately skilled professional or by facility staff who receive instruction from an appropriately skilled professional.

(2) Ensuring that prior to facility staff performing a range of motion or other prescribed exercises, there shall be written documentation by the appropriately skilled professional, outlining instruction on the procedures and the names of the facility staff receiving instruction.

(3) Ensuring that the professional reviews staff performance as often as necessary, but at least annually.