Failure to Maintain Resident's Nutritional and Hydration Status
Penalty
Summary
The facility failed to maintain the nutritional and hydration status of a resident, as evidenced by the lack of appropriate interventions and monitoring. The resident experienced significant weight loss over a period of six months, which was not adequately addressed by the facility's staff. Despite the resident's preferences and dietary needs being known, the facility did not provide suitable alternatives or ensure the resident received the necessary nutrition and hydration. Observations revealed that the resident often had untouched meals and supplements, and there were instances where no lunch tray was provided. The facility relied on the resident's family to bring in preferred foods during their infrequent visits, which was not a reliable intervention. The staff failed to consistently monitor and record the resident's intake of physician-prescribed supplements, and there was no evidence of weekly monitoring of the resident's nutritional status. Interviews with staff indicated a lack of awareness and action regarding the resident's nutritional needs. The staff did not implement or document necessary interventions, such as offering suitable substitutes or adjusting the resident's diet to meet their preferences and needs. The facility's policies on weight management and nutritional procedures were not followed, leading to the resident's continued weight loss and inadequate nutritional support.
Plan Of Correction
Element 1 Resident #67's diet was liberalized to regular. [R]NJ Exec Order 26.4b1 was increased from three times a day to four times a day. The physician added an [R]NJ Ex Order 26.4(b)(1) and provided [R]NJ Ex Order 26.4(b)(1) that the resident enjoys based on their [R]EXOT preferences and enjoyment of a [R]. Element 2 [R]NJ Ex Order 26.4(b)(1) All residents have the potential to be affected by this deficiency. Element 3 The facility has hired an experienced Dietician with extensive knowledge in the management of residents with weight loss. Additionally, a Weight Loss audit is being conducted to review newly identified significant weight losses (5% weight loss in 30 days, or 10% weight loss in 180 days) in order to remain in compliance with F692. This audit began on 1/27/2025 and is reviewing all residents in the facility. The results of the audit indicated one newly identified weight loss in the month of January. Element 4 To maintain and monitor ongoing compliance, the Weight Loss audit is being conducted by the Dietician or designee once a week for two months, then once every other week for two months, and then once a month for two months. Identified issues will be corrected as they are discovered, results will be reported to the Administrator and will be reviewed at quarterly Quality Assurance Performance Improvement meetings for six months to the Quality Assurance Performance Improvement team for review and action as necessary.