Failure to Maintain Dialysis Communication and Adhere to Fluid Restrictions
Penalty
Summary
The facility failed to maintain consistent communication regarding dialysis care for two residents who required such services and did not ensure that care and treatment orders, including fluid restrictions, were followed for one resident. For one resident with diagnoses including heart failure, renal insufficiency, and hypertension, dialysis communication forms were found to be incomplete on multiple occasions, as confirmed by an LPN. For another resident with dementia, dependence on renal dialysis, and hypertension, the facility did not adhere to a physician-ordered daily fluid restriction on several days, with documented fluid intake exceeding the prescribed limit. Additionally, required dialysis communication sheets were missing for several treatment dates. Interviews with staff, including LPNs and the Director of Nursing, confirmed these deficiencies, specifically the lack of completed communication forms and failure to maintain fluid restrictions as ordered. Facility policies required tracking of intake/output per provider order and consistent communication with the dialysis provider before and after each treatment, but these procedures were not consistently followed for the residents in question.