Failure to Provide Adequate Hydration Care and Services
Penalty
Summary
The facility failed to provide adequate hydration care and services to one resident who was dependent on staff for activities of daily living and had moderate cognitive impairment. The resident had a physician's order to increase water intake by mouth, specifically eight ounces three times daily between meals. Observations revealed that the resident did not have water, a water pitcher, or a water glass within reach at multiple times throughout the day. Bottled water and a gallon of water were present in the room but were out of the resident's reach. After lunch, all fluids were removed from the room, and no water or fluids were left accessible to the resident. Interviews with facility staff, including the DON, Administrator, LPN, and CNA, confirmed that the expectation was for residents to have fresh water available at all times unless contraindicated. Staff acknowledged that water had not been provided to the resident during the morning and that the process for providing water was not consistently followed. The LPN admitted to not providing any fluids to the resident before lunch and was unsure of the amount consumed. The facility's policy required nursing assistants to provide water at the bedside, but this was not adhered to for the resident in question.