F0692

D

Failure to Provide Ordered Extra Fluids for Hydration

Bellaire, Ohio Survey Completed on 03-17-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to provide ordered fluids to maintain a resident’s hydration status. The resident had diagnoses including recurrent urinary tract infections, hypotension, gastric reflux, protein-calorie malnutrition, and dysphagia, and had a dietary recommendation for 1950 ml fluid intake daily. After a hip fracture and readmission, the dietitian documented a recommendation and an order was obtained for an extra 240 ml of fluids with lunch and dinner, and this was also reflected on a diet order and communication form. Fluid intake records from 02/11/26 to 03/12/26 showed the resident’s intake per meal ranged from 60–240 ml, with an average daily intake of 760 ml, and there were days with missing meal intakes and several recorded refusals. There was no evidence in the records or care plans that the ordered extra 240 ml of fluids at lunch and dinner was being consistently provided or documented.

Surveyor review of a supper meal ticket showed no indication of the extra 240 ml fluid order, and observation of the resident at supper revealed only one 240 ml cup of beverage and a 120 ml cup of UTI supplement, not the ordered additional fluids. The Dietary Manager stated she was unaware of the extra fluid order and confirmed that special dietary instructions should appear on the meal ticket and a reminder sheet in the kitchenette; the extra fluid order was not listed on that sheet. An LPN reviewed the orders with the surveyor and confirmed the resident was supposed to receive extra fluids with lunch and dinner, but this had not been communicated to dietary. The resident’s daughter reported concerns about inadequate hydration, including decreased urination, dark urine, and recurrent urinary tract infections, and stated she did not feel her concerns about her mother’s hydration needs had been addressed.