Failure to Ensure Bedside Hydration for Residents at Risk of Dehydration
Penalty
Summary
Surveyors identified a deficiency in the facility’s failure to reasonably accommodate residents’ hydration needs and preferences by not ensuring fluids were available at bedside for three residents assessed as at risk for dehydration. One resident with diagnoses including stroke, chronic kidney disease, and UTI, and care plans identifying risk for dehydration, diuretic use, and constipation with interventions to encourage and offer fluids, reported only receiving fluids with meal trays. The resident’s family member, who visited daily, stated the resident never had fluids in the room and that the family had to provide fluids every day. Another resident, cognitively intact with diagnoses including CHF and iron deficiency anemia and a care plan indicating risk for dehydration with an intervention to offer fluids, was observed in the morning with a Styrofoam cup containing only a small amount of water and reported that no water had been brought that day and that sometimes he had to ask for it. Later that day, he reported receiving fresh water for the first time about twenty minutes prior. A third resident, moderately cognitively impaired with diagnoses including severe sepsis with septic shock and acute respiratory failure with hypoxia, and care planned as at risk for dehydration with an intervention to offer fluids, was twice observed with an empty Styrofoam cup without a date, first stating she always had to ask for water and later indicating the empty cup with ice came on her lunch tray and that water had still not been passed. The Administrator stated there was no facility hydration policy and that water cups were passed once per shift.
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