Failure to Provide Sufficient Fluids for Hydration
Penalty
Summary
The facility failed to provide sufficient fluids to maintain adequate hydration for one resident, as required by facility policy and the resident's care plan. Multiple observations over several days revealed that the resident did not have a water pitcher or any other fluid for hydration at the bedside, despite being awake and alert in the room. The facility's policy mandates that a water pitcher with water and ice be placed at the bedside of all residents unless contraindicated, and that nursing assistants offer fluids every two hours unless restricted. Review of the resident's medical record showed no fluid restrictions, and both the CNA and LPN confirmed that the resident should have had a water pitcher available. The resident in question had a history of Alzheimer's, mild protein-calorie malnutrition, chronic ulcer, peripheral vascular disease, anxiety disorder, dysphagia, osteoarthritis, and a history of urinary tract infections. The care plan included interventions to encourage fluid intake, especially while on antibiotic therapy for a UTI, which required a minimum fluid intake per facility guidelines. Documentation of fluid offers was inconsistent and did not meet the every-two-hour standard. Staff interviews confirmed the absence of a water pitcher and acknowledged that the resident should have had one at the bedside.