Failure to Provide Pre-Dialysis Meal or Snack to Resident
Penalty
Summary
The facility failed to provide a light meal or snack to a resident prior to the resident leaving for dialysis, as required by the facility's Dialysis Policy. The policy specified that nutritional and fluid management for dialysis residents should include meals before, during, and after hemodialysis, with monitoring of intake and output as ordered. The resident, who had multiple diagnoses including end stage renal disease, dependence on dialysis, congestive heart failure, and diabetes, reported that staff did not offer her anything to eat before dialysis and that she typically had to wait until after returning from dialysis to eat her lunch, which was left on her table during her absence. Interviews with staff revealed a lack of consistent practice regarding the provision of snacks or meals to residents going to dialysis. One CNA stated she did not offer snacks or lunch because the resident left right after breakfast, while another CNA also confirmed not offering snacks to dialysis residents. The nurse interviewed stated that all staff were responsible for ensuring dialysis residents received a snack or lunch before leaving, and the Dietary Manager indicated that sack lunches or snacks were prepared depending on the dialysis schedule. However, the Director of Nursing was unaware that staff were not offering snacks or lunch to residents going to dialysis, indicating a breakdown in communication and adherence to policy.