Failure to Provide and Offer Bedtime Nourishing Snacks
Penalty
Summary
The facility failed to provide and offer nourishing bedtime snacks to residents in accordance with its own policy and resident needs and preferences. The facility’s undated Between Meal Snack/Bedtime Nourishments policy required that between-meal snacks and bedtime nourishments be offered to all residents unless contraindicated by a physician’s diet order, and specified that bedtime nourishment must consist of nourishing foods such as milk, 100% fruit juice, cookies, crackers, and fruit. The policy also stated that dietary should develop a snack nourishment stock level for each nursing station and that nursing staff were to pass snacks and nourishments from room to room, with an explicit statement that it was not acceptable to simply announce snacks from the nursing station. Surveyor review of Resident Council meeting minutes showed that residents had previously reported problems with snack availability and distribution. In one meeting, residents were told by a nurse that there were no snacks at the nurse’s desk, and in another, residents reported that dietary was not passing out snacks. During a group interview with eight alert and oriented residents, six reported they were not offered snacks at bedtime, and one reported that snacks were sometimes available at the nurse’s station for residents who could ambulate there, but staff did not come to resident rooms to offer snacks. Observations over several days showed no snacks at the nursing stations on three units. The Dietary Aide confirmed the scheduled meal times, and the Dietary Manager acknowledged that snacks had not been provided to nursing staff for delivery to residents. This deficiency affected all residents who ate at the facility, with a census of 83.
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