Failure to Provide and Document Evening Snacks for Residents
Penalty
Summary
The facility failed to ensure that residents received and were properly documented as having received a nourishing evening snack when there was more than a 14-hour span between dinner and breakfast. During a kitchen tour, the Food Service Director confirmed that evening snacks were not routinely sent, and there was no list of residents receiving snacks. Instead, labeled snacks were provided only if requested before the kitchen closed, and after hours, snacks could be accessed by a supervisor with a key. Review of the facility's mealtime schedule confirmed that the interval between dinner and breakfast exceeded 14 hours. Resident council meeting participants, all of whom were alert and oriented, reported that labeled snacks were inconsistently distributed by CNAs, and when left unattended at the nurse's station, snacks were sometimes taken by other residents. There were no additional snacks available for residents without labeled snacks. Interviews with nursing staff and the unit manager revealed that there was no accountability system, either in the electronic medical record or on paper, to track the provision of evening snacks or to document refusals. The Registered Dietitian and Food Service Director both acknowledged the need for snacks when the meal interval exceeded 14 hours and agreed that accountability was lacking. Review of previous resident council meeting minutes showed ongoing reports that CNAs did not distribute snacks as intended. The facility was unable to provide policies related to mealtimes and evening snacks.