Failure to Provide Consistent Drinking Water
Penalty
Summary
The facility failed to provide drinking water consistent with resident needs and preferences on one of its units, specifically the D-female dementia unit. Observations on January 7, 2025, revealed that several resident rooms lacked water cups or accessible drinking water, while other rooms had Styrofoam water cups with outdated dates, some of which were empty or contained warm water. Facility protocol requires night shift nursing staff to replace and date these cups, but this was not adhered to, as confirmed by staff interviews. Interviews with staff and a resident's family member highlighted the inconsistency in providing fresh water. An LPN and an agency nurse aide both acknowledged that the night shift staff is responsible for replacing and dating the water cups, and that nurse aides are expected to refill them during each shift. However, they confirmed that water had not been passed that morning. A resident's daughter expressed concern that her mother, who needs encouragement to drink, does not consistently receive fresh water, which could impact her hydration needs. The Nursing Home Administrator confirmed the protocol but acknowledged the failure to ensure the availability of drinking water as required.
Plan Of Correction
D unit corrected day of revisit 1/7/25. House audit completed on 1/7/25 for availability of drinks. Policy entitled, "Water Pass", reviewed for any updates. All staff in-serviced on facility policy. The DON or designee will be completed random weekly audits of resident water cups to ensure they being replaced consistently x 4, then monthly x 2. Audits be presented at monthly QAPI committee for ongoing oversight.