Failure to Ensure Hydration Within Reach for Resident with Cognitive and Physical Impairments
Penalty
Summary
A deficiency occurred when staff failed to ensure that a resident with severe cognitive impairment and left-sided weakness consistently had access to adequate hydration within reach. The resident, who required partial assistance with eating and had a care plan specifying the need for tray setup and placement of items on her right side, was observed multiple times with her water mug placed out of reach. Family members and staff interviews confirmed that the water mug was often left across the room or on the resident's left side, which she could not access due to hemiparesis from a stroke. The resident herself reported being unable to reach her water mug and experiencing thirst as a result. Observations on several occasions showed the water mug placed behind the resident, across the room, or on the left side, all out of her reach. Staff acknowledged that the standard practice was to keep the water mug next to her, but this was not consistently followed. The facility's policy directed staff to offer fluids during scheduled care but did not specify the need to keep water within reach when appropriate. The director of nursing stated that her expectation was for staff to place water within reach to prevent dehydration, but this was not consistently implemented for the resident.