Failure to Provide Consistent Mealtime Assistance and Supervision
Penalty
Summary
A deficiency was identified when a resident with Alzheimer's disease, severe cognitive impairment, and multiple ADL (activities of daily living) dependencies did not receive consistent assistance and supervision during mealtimes. The resident's care plan and assessments specified the need for staff to provide substantial to maximal assistance with eating, supervision during meals, and encouragement to eat in the dining room for proper monitoring. The care plan also instructed that the resident should not be left alone in her room while eating and required staff to provide feeding assistance and cues. Observations revealed that on multiple occasions, the resident was served meals in her room without staff present to assist or supervise her. On two separate mornings, the resident was found in bed with her meal and nutritional supplement left at her bedside, with no evidence of staff assistance. The call light was not within her reach, and staff were not present as she consumed her meal. Only on one occasion was staff observed staying in the room to assist the resident during her meal. Interviews with nursing and aide staff confirmed that facility policy and the resident's care plan required staff to supervise and assist the resident during meals, especially due to her cognitive and communication deficits. Staff acknowledged that the resident should not be left alone to eat in her room and that the call light should be accessible. The facility's policy on activities of daily living also required staff to provide necessary assistance to maintain residents' abilities.