Failure to Provide Safe Dialysis Care and Adhere to Dietary Restrictions
Penalty
Summary
The facility failed to provide safe and appropriate dialysis care and services for a resident requiring hemodialysis. Review of the resident's medical record revealed missing and incomplete Hemodialysis communication sheets on several dates, with the post-dialysis section left blank and not completed by nursing staff upon the resident's return from dialysis. This was confirmed by the Director of Nursing. Additionally, after the resident returned from the hospital following the placement of an arteriovenous fistula (AVF), there was no physician order or care plan in place to monitor the AVF for bruit and thrill as requested by the hospital, despite the resident expressing anxiety and requesting monitoring. The facility also failed to ensure the resident's dietary restrictions were followed. The resident had a diet order restricting tomatoes and oranges, yet the menu options provided included tomato products and oranges. During observation, the resident was served a meal containing both restricted items, and she expressed that she did not request those foods. The nurse aide confirmed the contents of the tray and offered to get the resident pudding, which was her preference. The previous Nursing Home Administrator later presented a meal selection sheet indicating the resident had chosen an option that still included restricted items, and did not address the issue when it was pointed out.