cms_WV: 119
Data source: Big Local News · About: big-local-datasette
| rowid | facility_name | facility_id | address | city | state | zip | inspection_date | deficiency_tag | scope_severity | complaint | standard | eventid | inspection_text | filedate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 119 | HUNTINGTON HEALTH AND REHABILITATION CENTER | 515007 | 1720 17TH STREET | HUNTINGTON | WV | 25701 | 2017-09-07 | 279 | D | 0 | 1 | QLZ111 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, resident interview and staff interview, the facility failed to identify and develop a comprehensive care plan for significant weight loss for one (1) of twenty-nine (29) residents reviewed during Stage 2 of the Quality Indicatior Survey. Resident Identifier: #320. Facility Census: 180 Findings include: a) Resident #320 Resident #320 lost 10.8% (percent) of his body weight, from 04/22/17 to 05/05/17, which represented a severe weight loss. Additionally, Resident #320 lost 13.1% of his body weight from 04/22/17 to 06/04/17, which again represented a severe weight loss. There was no evidence the facility identified these weight losses nor assessed causes and/or provided interventions to prevent additional weight loss. A record review on 09/05/17 at 12:08 p.m., revealed the Nursing Initial Plan of Care completed on 04/22/17, Section E. Nutrition, 1. Focus, 2. Goal, 3. Interventions, and 4. Responsible Disciplines had no responses. It was signed by Employee #87. The Nursing Care Plan completed on 06/06/17, which was the current care plan at the time of this review, stated, Focus: (First name of resident #320) has nutritional problem or potential nutritional problem (skin breakdown) r/t Obesity (weight 277, BMI/IBW 34.6/196-206). Date Initiated: 04/28/2017. Revision on: 04/28/2017. Goal: (First name of resident #320) will have gradual weight loss (1-2 lbs per month) through review date. Date Initiated: 04/28/2017. Revision on: 05/03/2017. Target Date: 08/02/2017. (Resident #320's last name) will maintain adequate nutritional status as evidenced by maintaining weight within (10)% of (196), no s/sx of malnutrition, and consuming at least (50)% of at least (2) meals daily through review date. Date Initiated: 04/28/2017. Revision on: 05/03/2017. Target Date: 08/02/2017. (First name of resident #320) will not develop complications related to obesity, includng skin breakdown, ineffective breathing pattern, altered cardiac output, diabetes, impaired moblity through review date. Date Initiated: 04/28/2017. Revision on: 05/03/2017. Target Date: 08/02/2017. Interventions: (included) Develop an activity program that includes exercise, mobility. Offer activities of choice to help divert attention from food. Date Initiated: 04/28/2017. Observe/record/ report to MD PRN s/sx of malnutrition: Emaciation (Cachexia), muscle wasting, significant weight loss. Date Initiated: 04/28/2017. RD to evaluate and make diet change recommendations PRN. Date Initiated: 04/28/2017. Weigh at same time of day and record each month. Date Initiated: 04/28/2017 Revision on 04/28/2017. A record review on 08/30/17 at 8:28 a.m., revealed the folllowing weights for Resident #320: -- 04/22/17: 277.0 pounds -- 05/05/17: 247.0 pounds (-10.8%, -30.0 pounds) -- 06/04/17: 240.8 pounds (-13.1%, -36.2 pounds) The resident's percentage of weight loss from 04/22/17 to 05/05/17 and from 04/22/17 to 06/06/17 were calculated using the following formula % of weight loss = (usual weight - actual weight) / (usual weight) x 100. -- From 04/22/17 to 05/05/17, the resident lost 10.8% of his body weight. -- From 04/22/17 to 06/04/17, the resident lost 13.1% of his body weight. Review of resident #320 physician's orders [REDACTED]. Dietary supervisor clarified this order as Controlled Carbohydrate Diet, No Added Salt Diet, Regular Texture, Regular Consistency. From 4/22/17 to 5/19/17, two (2) Nutrition Data Collection had been completed. The first note, description admitted d 4/22/17 at 12:00 p.m., signed and locked 4/28/17 at 2:17 p.m The most recent weight was noted in Section A: 277.0 Lbs on 4/22/17 at 1:54 p.m. The Diet/Supplement/Snack/Fortified Foods was noted in Section I, 2 Regular Diet and the Average meal intake percentage/day was noted in Section A: 1,3 50-75%. The Summary/Plan/Progress Note was noted in Section K,2, which included, Resident evaluated for initial admission nutritional status. Current diet is NAS with average intake of 75-100%, which is adequate to meet needs. Weight is 277/34.6, and indicates overweight/obesity status. Current diet order is adequate and appropriate. Will follow prn. The second Nutrition Data Collection dated 5/19/17 at 10:45 a.m., signed and locked 5/30/17 at 09:24 a.m. by Employee #182. The most recent weight was noted in Section A: 249.6 on 5/10/17 at 09:39. Section B, Weight Status, 1. Is there a change in weight? Response: a. No Change. In 3. Weight Loss =/> 5% in 30 days, 7.5% in 90 days, or 10% in 180 days?; however, there was No Response noted in this section. In 4. Please select concerning =/> 5% weight loss; however there was No Response noted in this section. In Section I, 2,Diet/Supplement/Snack/Fortified Foods: CCD/NAS/REG texture. Section I. 3 Average meal intake percentage/day: 100%. In Section K Summary/Plan/Progress Note: Pt with history of GERD/T2DM/Unsteady Gait/Pt is post home-invasion with facial trauma. No problems with eating. Glucose is running elevated. He has a history low H&H and depressed [MEDICATION NAME]. Per pt he has no problems. The Nutrition RD assessment dated [DATE] at 09:03 a.m., signed and locked 5/3/17 at 09:06. Section A: Nutrient Estimated Needs, 1. Calories: 20-25/kg ABW of 98kg=1965-2450. 2. Protein: 1-1.1g/kg ABW=98-108. 3. Fluid: 1mL/kcal= 1965-2450. Section B : Nutrition Diagnosis, 1d. Predicted excessive energy intake NI-1.5. Section C: Problem/Etiology/Signs/Symptoms Statement, 3. Nutrition Goals: Maintain/improve nutritional status. Slow, gradual wt. loss of 3-5 # per month. Avg intake >50%. The Nutrition Status Review dated 7/22/15 at 12:00 p.m, signed and locked 7/29/17 at 5:40 p.m Section B: Weight Status, 3 Weight Loss =/> 5% in 30 days, 7.55 in 90 days, or 10% in 180 days?: No Response. In 4. Please select concerning =/>5% weight loss: No Response. The Nursing Monthly Summary for Resident #320, dated 6/23/17 at 2:00 p.m., signed and locked 6/23/17 at 3:09 p.m., noted Eating 4h: Usual Appetite: b. Fair. Interview was conducted with Resident #320 on 9/5/17 from 1:45 PM-2:30 p.m. The resident explained the events that led up to his admission in April, as well as the therapy received initially. He stated that his appetite when first admitted to the facility was I don't remember much when I first came here. I guess I ate pretty good. I don't really know. I don't have any problem eating now, though. When asked if he was aware he had lost weight after his admission, he replied, No, I really don't. They keep record of it I guess, so I guess they took care of it. Resident #320 said, I don't have any problems eating now. When asked if the staff ever offer him something else to eat, if he doesn't eat and/or like what has been served, he replied, No, I guess they would if I'd ask. Interview was conducted with Employee #40 on 9/7/17 at 9:17 a.m. regarding Resident #320's noted weight loss for April, (MONTH) and (MONTH) (YEAR). She reviewed the Weight Summary report and noted the weight loss for this time period and stated I'll have to talk with (First name of Employee #180) and check if there were interventions for his weight loss. No other information was provided during the survey. | 2020-09-01 |