Failure to Provide Adequate Nutrition, Meal Replacements, and Weight Monitoring
Penalty
Summary
Staff failed to provide adequate nutritional care and meal replacements for multiple residents who consumed less than 50% of their meals. In one instance, a resident who was unable to feed themselves was left with a meal tray and not assisted until nearly an hour later, by which time the food was cold. The resident consumed less than 10% of the meal, and staff did not offer or document a meal replacement, contrary to facility policy. Staff interviews confirmed that meal replacements should be offered and documented when residents consume less than half of their meal, but this was not done. Another resident with diagnoses including morbid obesity, heart failure, and malnutrition, and who was lactose intolerant and diabetic, frequently refused facility meals. Staff offered inappropriate snacks such as milk and high-sugar items, despite knowing the resident's dietary restrictions. When the resident refused meals, staff did not consistently offer suitable meal alternatives or ensure that outside food was properly stored, as required by facility policy. Staff interviews revealed uncertainty about the provision of supplements and the storage of outside food. A third resident, at risk for malnutrition and with dysphagia, had physician orders for regular weight monitoring. Staff failed to obtain and accurately document weights as ordered, with several entries missing or marked as refused without evidence of alternative attempts. Staff acknowledged the failure to follow physician orders and the need for alternative weighing methods for residents who refuse care. These deficiencies in nutritional care, meal replacement, and weight monitoring were observed and confirmed through staff interviews and record reviews.