Failure to Provide Routine Nightly Snack to Diabetic Resident
Penalty
Summary
A deficiency occurred when the facility failed to provide a suitable, nourishing snack to a resident with type 2 diabetes who required routine nightly snacks to help manage blood sugar levels. The resident, who had moderate cognitive impairment and was on a controlled carbohydrate diet with scheduled insulin administration, experienced multiple episodes of low blood sugar (below 70) in the mornings, as documented in the Medication Administration Record. Despite facility policy requiring bedtime snacks for residents unless contraindicated, documentation showed inconsistent provision and recording of snacks, with only a few instances noted and no documentation of resident refusal. Interviews with staff, including a registered nurse, CNA, and the DON, confirmed that snacks should be offered nightly to diabetic residents and that documentation of snack provision or refusal is required. However, review of the records revealed a lack of consistent documentation and no evidence that the resident was routinely offered or received a nightly snack, despite ongoing low blood sugar readings. The DON acknowledged that the resident should have been receiving a nightly snack and that there was no documentation of refusal.