Lack of Policy for Physician Delegation to Dietitian
Summary
The facility failed to develop a policy and procedure for the delegation of tasks by physicians to the dietitian. This deficiency was identified during a review of facility policies, which revealed the absence of a procedure for physician delegation of tasks to the dietitian. The administrator confirmed the lack of such a policy or procedure when interviewed, indicating that no documentation could be found to address this delegation process. This oversight had the potential to impact all 69 residents residing at the facility.
Penalty
Resources
Below are regulatory guidelines relevant to this citation:
A resident experienced significant weight loss due to swallowing difficulties and dehydration, but was not referred to a dietitian for nutritional support. Despite regular assessments by a CRNP, the resident's poor oral intake was not communicated by nursing staff, leading to the deficiency being identified during a complaint survey.
Failure to Refer Resident for Nutritional Support
Penalty
Summary
A facility provider failed to refer a resident's case to a dietitian when the resident required additional nutritional supplementation. The resident, who had a history of swallowing difficulties and dehydration, experienced significant weight loss from 124 lbs to 104 lbs between June and July 2022. Despite being assessed by a Certified Registered Nurse Practitioner (CRNP) twice a week during June 2022, there was no evidence of a referral to a dietitian for increased nutritional support. The resident was eventually given a PEG tube after a hospital readmission, but the initial weight loss and lack of referral were not addressed in a timely manner. The CRNP confirmed that the resident was being treated for multiple conditions, including COVID-19 and a urinary tract infection, during the month of June 2022. The CRNP also stated that the facility's nursing staff failed to inform him/her of the resident's poor oral intake, which contributed to the resident's weight loss. The deficiency was identified during a complaint survey, and the facility's administrator and Director of Nursing were informed of the deficient practice.
Trusted data from CMS and state health departments
Every citation, penalty and Plan of Correction is sourced from public CMS records (latest release May 27, 2026) and official state health department websites — never guesswork.
Trusted by long-term care providers and associations.
