Failure to Administer Ordered Nutritional Supplements and Appetite Stimulant
Penalty
Summary
A resident with diagnoses including prostate and bone cancer and difficulty swallowing was identified as being at risk for malnutrition due to increased nutritional needs, poor appetite, and altered skin integrity. The resident's care plan included interventions such as providing nutritional supplements and an appetite stimulant as ordered by the physician. Physician orders specified a daily house shake and Megestrol Acetate Oral Suspension for appetite stimulation. However, review of the Medication Administration Record (MAR) revealed that the resident did not receive the Megestrol Acetate Oral Suspension on multiple dates, with nursing notes incorrectly documenting the medication as unavailable, despite pharmacy records confirming its delivery and availability. Additionally, the resident did not receive the ordered house shake supplement on several dates, with nursing notes again indicating it was not available, while the Dietary Manager confirmed that house shakes were always prepared and distributed daily. During this period, the resident experienced a 6.9-pound weight loss, representing a 4.3% decrease in total body weight. The Director of Nursing confirmed that both the medication and supplement were available but were not administered as ordered.