Failure to Address Significant Weight Loss in Resident
Penalty
Summary
The facility failed to maintain acceptable parameters of nutritional status and provide timely nutritional interventions for a resident. The resident was admitted with several diagnoses, including major health conditions, and experienced a significant weight loss trend of 10.30 percent since admission. The facility's policy required that residents' nutritional status be monitored and significant changes be addressed by notifying the dietitian and revising the care plan. However, the dietitian did not review the complete history of the resident's weight loss, and the necessary interventions were not implemented in a timely manner. Interviews with facility staff revealed that the Clinical Dietitian, who worked part-time, was responsible for conducting nutritional assessments and was aware of the criteria for significant weight loss. Despite this, the dietitian did not adequately address the resident's weight loss, and the facility's procedures for managing significant changes in nutritional status were not followed. The General Manager for Dining noted that food preferences, such as double portions, were entered into the resident's chart, but this did not prevent the resident's continued weight loss.
Plan Of Correction
POC for Citation N201 This plan of correction is the facility's credible allegation of compliance. Preparation and/or execution of this plan does not constitute admission nor agreement by the provider of the truth and facts alleged nor conclusions set forth in the statement of deficiencies. The plan of correction is prepared and/or executed solely because it is required by provisions of federal and state law. Resident #23 had a loss which was reviewed by the Registered Dietician. Both resident's son and PCP were aware of his stated loss. Care plan was updated by Clinical Team to include the following new interventions: - Daily per Registered Dietician - Continue double portion meals and ensure shakes increased from daily to twice a day - Lab work (. CMP, Pre-Resident was daily until with fluctuations between 118- consistently, and consuming 100% of meals. Per dietician, despite consuming 100% of meals (double portions) and ensure supplement, the resident continues to experience unintentional loss. Order was received to discontinue daily and new order was given for weekly. During conversation with Resident #23's son on to give an additional follow-up regarding his current status, he requested a hospice consult and was signed onto hospice effective. The Registered Dietician, ADON, or designee will conduct an audit of current Skilled Nursing residents to identify loss and ensure proper nutritional interventions are in place. Any discrepancies will be addressed promptly. The Staff Development Coordinator or designee will educate the Registered Dietician and Nursing staff on the facility policy for management. The ADON or designee will review the report and clinical notes during morning clinical meeting to identify a loss or change in condition to ensure proper nutritional interventions are in place promptly. The Registered.