Failure to Provide Appropriate Meal Assistance for Two Residents
Penalty
Summary
The facility failed to provide appropriate meal assistance to two residents who required support with activities of daily living, specifically eating. One resident with dementia, vision impairment, and dysphagia was observed on multiple occasions receiving no staff assistance with meal setup or feeding, despite care plan interventions specifying the need for adaptive utensils and divided plates. This resident was served meals in bed with covered trays and was not assisted by staff, resulting in poor or no meal consumption. Staff interviews revealed a lack of awareness regarding the resident's need for feeding assistance, and the resident was not included on the feeding assistance list at the nurse's station. Another resident with quadriplegia, multiple sclerosis, and a history of dysphagia was also not provided with the required supervision or cueing during meals. This resident was served meals in bed with the door closed and received no observed assistance, leading to poor meal intake and refusal of food. The resident's care plan did not address eating ability or ADL needs, and there was inconsistency between the feeding assistance list and the diet order instructions. Staff interviews confirmed that the resident was supposed to receive supervision or cueing during meals, but this was not provided. Observations, record reviews, and staff interviews demonstrated that the facility did not follow its own policy to provide assistance with activities of daily living based on individual care needs. Both residents experienced inadequate meal assistance, with staff either unaware of or not following care plan interventions and feeding lists, resulting in poor nutritional intake.