| 53 |
MINOT HEALTH AND REHAB, LLC |
355031 |
600 S MAIN ST |
MINOT |
ND |
58701 |
2019-06-11 |
677 |
E |
1 |
0 |
HFFF11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > THIS IS A REPEAT DEFICIENCY FROM SURVEYS COMPLETED ON 08/16/18. Based on information received from the complainants, observation, record review, and staff interview, the facility failed to provide dining assistance for 2 of 16 sampled residents (Resident #1 and #14) and 3 supplemental resident (Resident #22, #23, and #24) observed during meals. Failure to reposition, cue, and/or assist dependent residents may result in decreased intake and/or unwanted weight loss. Findings include: Information provided by the complainants indicated nursing staff failed to provide cues/assistance for residents with vision and/or mobility deficits. Upon request, the facility failed to provide a copy of their policy addressing dining assistance. Staff indicated they provide standard of practice based on resident's individualized needs. - Review of Resident #1's medical record occurred on all days of survey. [DIAGNOSES REDACTED]. The current care plan stated, . self care deficit . requires assistance related to: disease process, physical limitation, [MEDICAL CONDITION] . Assist with daily . grooming . oral care . and eating as needed . Upper and lower dentures. Observation on 06/05/19 at 8:35 a.m., showed Resident #1 sitting in bed holding a piece of toast with a breakfast tray in front of her. Resident #1's eyes had yellowish crusty matter around the eye lids. The resident stated, my eyes are blurry. Resident #1 asked for assistance obtaining her dentures. Resident #1's dentures were located on the sink. During an interview on 06/05/19 at 8:40 a.m., a certified nursing assistant (CNA) (#4) stated the CNA's try to do morning cares before the residents eat, but will try again after breakfast if they refuse. The CNA (#4) acknowledged she set-up Resident #1's breakfast tray. The CNA (#4) failed to give Resident #1 her dentures prior to providing tray set-up. - Review of Resident #14's medical record occurred on all days of survey. The current care plan identified, . self care deficit as evidenced by requires assistance related to: disease process dementia, physical limitations. Assist with . eating as needed . Nutritional status as evidenced by mechanically altered diet and varying intakes that are overall poor. I need more assistance at meals . Encourage as needed to consume foods and/or supplements and fluids offered . Observation on 06/04/19 at 12:25 p.m. showed a CNA (#9) giving Resident #14 sips of cocoa from a cup. Resident #14's alertness level varied throughout the meal and she sat leaning heavily to her right side (with her head directly over the arm rest of her chair). The CNA (#9) failed to ensure Resident #14 was alert enough to safely eat/drink and failed to reposition her. - Review of Resident #22's medical record occurred on all days of survey. The current care plan identified, . self care deficit as evidenced by: need for increased assistance with . tasks related to: disease process, [MEDICAL CONDITION] with physical limitations . Assist with . eating as needed . At risk for nutritional status wt. (weight) change r/t (related to) variable oral intake . Encourage and assist as needed to consume foods and/or supplements and fluids offered . Observations showed the following: * 06/04/19 at 12:25 p.m., Resident #22 sat at an assisted table and stared straight ahead. She made no effort to eat. Staff failed to cue and/or assist Resident #22 throughout the meal. Total intake consisted of a cup of cocoa. * 06/05/19 at 12:12 p.m., Resident #22 sat at an assisted table and stared straight ahead. She made no effort to eat. An office staff member (#14) sat down to assist Resident #22 with her meal approximately fifteen minutes into the meal. - Review of Resident #23's medical record occurred on all days of survey. The current care plan identified, . self care deficit as evidenced by requires assistance related to: disease process, physical limitations . Assist with . eating as needed . Resident need to be positioned at 90 degree angle during . oral intake . Nutritional status increase need related to open areas Hospice care . Encourage and assist as needed to consume foods and/or supplements and fluids offered . Observation on 06/04/19 at 12:25 p.m. showed Resident #23 sat at an assisted table and leaned heavily to his right side (with his head directly over the arm rest of her chair) with his left hand wrapped with gauze. Resident #23 dropped food onto his clothing protector/pants while attempting to feed himself. The CNAs sitting at the table failed to reposition and/or assist the resident. An unidentified staff member repositioned Resident #23 and sat down to assist him approximately eleven minutes into the meal. - Review of Resident #24's medical record occurred on all days of survey. The current care plan identified, . self care deficit as evidenced by: need for staff performance of cares related to: disease process advanced dementia . Reposition at routine intervals before . meals . Requires total assist with . eating . Nutritional status as evidence by weight gain related to improved eating and inactivity. He . has a need for assistance or cueing at meals . Assist as needed to consume foods and/or supplements and fluids offered . Observation on 06/04/19 at 12:25 p.m. showed an unidentified CNA feeding Resident #24. Staff had raised the back of Resident #24's chair to an approximate 60 degree angle. The CNA (#9) failed to reposition the resident and left him in a reclined position throughout the meal. Staff failed to ensure alertness, reposition, cue, and/or assist dependent residents who were at risk for aspiration, decreased intake, and/or unwanted weight loss. Refer to F692. |
2020-09-01 |