Failure to Provide Timely Meal Assistance to Dependent Residents
Penalty
Summary
The facility failed to provide timely and appropriate meal assistance to two residents who required help with eating during observed meal services. One resident with dementia and significant cognitive impairment was left seated at a dining table without a meal tray for 24 minutes while others at the table were eating, and then waited an additional 18 minutes with her meal tray in front of her without receiving any staff assistance to eat. This resident was unable to self-feed and required substantial or maximal assistance, as documented in her care plan and medical record. Staff interviews confirmed that the resident should not have waited so long for assistance and that there was sufficient staff present to provide the necessary help, but the resident was overlooked during the meal service. Another resident with diagnoses including dementia, aphasia, dysphagia, and a history of malnutrition was observed to receive a meal tray but did not attempt to eat and was not approached by staff for assistance for at least ten minutes. When staff did assist, the help was intermittent and inconsistent, with staff leaving the resident to assist others and not returning promptly. The resident required set-up, encouragement, and sometimes physical assistance to initiate and continue eating, as documented in the care plan and therapy notes. Staff interviews revealed uncertainty about the resident's care plan requirements, and some staff were unaware of the specific level of assistance needed, leading to delays and inadequate support during meals. Both residents had documented needs for meal assistance in their care plans and medical records, including requirements for physical help, verbal cues, and encouragement to eat. Despite this, staff failed to provide timely and consistent assistance, resulting in prolonged periods where the residents were unable to eat or required prompting to begin eating. Facility policy required that meals not be served until an attendant was ready to assist, but this was not followed, contributing to the deficiencies observed during the survey.