Failure to Provide Nourishing Evening Snacks
Penalty
Summary
The facility failed to ensure the provision of a nourishing evening snack when more than 14 hours elapsed between the dinner meal and breakfast the following day for nine out of ten sampled residents. The facility's policy, last reviewed in June 2024, mandates that the time between a substantial evening meal and breakfast should not exceed 14 hours unless a nourishing snack is provided at bedtime. However, the scheduled mealtimes revealed a gap of 14.83 hours between dinner and breakfast, without the consistent provision of snacks. Interviews with residents indicated that snacks were not routinely offered or provided. Several residents reported that while a snack tray was sometimes left at the nurses' station, the snacks were not distributed to them. Some residents mentioned that they had to request snacks to receive them, and others noted that snacks were previously provided but had not been for months. The Nursing Home Administrator was unable to explain why residents were not routinely offered and provided with an evening snack.
Plan Of Correction
- B15, B6, B7, B8, B9, B150 (typo) B15, B11, B12 and B13 - Assessed for preferences of h.s. snacks. - House audit completed on all other residents requiring an h.s. snack and preferences to meet the resident needs. On admission, readmission, quarterly and PRN, the residents will be interviewed to discuss preferences for h.s. snacks. - Policy entitled, "Frequency of Meals", reviewed and re-education provided to all nursing staff and dietary staff. Education to nursing staff also included not only providing the preferred snack to the resident but also providing assistance to those residents in need of assistance and documentation of the snack and if consumed. - Facility re-established par levels for each unit for snack options on 2/3/25. - The DON or designee will complete weekly audits x 4, then monthly x 2. Auditing will include random resident interviews on snacks delivery and preferences. - Audits will be presented at the monthly QAPI committee for ongoing oversight.