cms_WV: 127
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 127 | HUNTINGTON HEALTH AND REHABILITATION CENTER | 515007 | 1720 17TH STREET | HUNTINGTON | WV | 25701 | 2017-09-07 | 325 | D | 1 | 1 | QLZ111 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** > Based on medical record review, resident interview and staff interview, the facility failed to identify and address a severe weight loss for one (1) of three (3) residents reviewed for the care area of nutrition during Stage 2 Quality Indicator Survey. 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/ , 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 losses. As no interventions had been implemented, the weight loss could not be determined to be unavoidable. This represents actual harm to resident #320. Resident Identifier: #320. Facility Census: 180 Findings Include: a) Resident #320 A record review on 08/30/17 at 8:28 a.m., revealed the following 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. Review of resident #320 medical record found a Minimum data set (MDS) with an assessment reference date of 06/17/17. Section K of this MDS Swallowing/Nutritional Status K0300: Weight Loss of the MDS, indicated Resident #320 had not had a Loss of 5% or more in the last month or loss of 10% or more in last 6 months. Further review of the medical record found a 7/22/17: MDS Modified & Accepted; however, it was noted there were not any changes in Section K: Weight Loss: (Loss of 5% or more in the last month or loss of 10%in last 6 months): 0 NO or UNKNOWN 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/DM/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.Predicticted 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. The Quarterly MDS Review dated 6/17/17, 2. GO110-H Eating: Independent. 3. KO300. Weight: 258 lbs Weight Loss: (Loss of 5% or more in the last month or loss of 10%in last 6 months): 0 NO or UNKNOWN. The Modified & Accepted MDS dated [DATE] was reviewed, and there were not any noted changes in Section K. Weight Loss: (Loss of 5% or more in the last month or loss of 10%in last 6 months): 0 NO or UNKNOWN. Record review of the Resident #320's Monthly Meal Consumption documentation for April, (MONTH) and (MONTH) (YEAR), revealed the following findings: APRIL (YEAR): Total Meals Documented: 26 Percentage Guide 0 0-25% 0 1 26%-50% 5 2 51%-75% 14 3 76%-100% 7 MAY (YEAR): Total Meals Documented: 91 Percentage Guide Missed Documentation 2 0 0-25% 0 1 26%-50% 4 2 51%-75% 53 3 76%-100% 34 JUNE (YEAR): Total Meals Documented: 90 Percentage Guide Missed Documentation 0 0 0-25% 0 1 26%-50% 1 2 51%-75% 33 3 76%-100% 56 Review of Facility's Food Consumption Chart reference tool for staff reference, which gives the specific examples of 0%, 25%, 50%, 75% and 100%; however, the Facility failed to have a Food Consumption Chart reference tool for staff reference for examples of the percentage guide they currently use, which is 0 0-25%, 1 26%-50%, 2 51%-75%, and 3 76%-100%. During an interview conducted with Resident #320 on 9/5/17 beginning at 1:45 p.m., he explained to me the events that led up to his admission in April, as well as the therapy he received initially. I asked him how his appetite was when he was first admitted to the Facility, and he replied, 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. I asked him if he was aware he had lost weight after his admission, and he replied, No, I really don't. They keep record of it I guess, so I guess they took care of it. Resident #320 smiled and said, I don't have any problems eating now. I 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. During an interview 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). Employee #40 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 one provided this Surveyor with any additional and/or follow-up information. 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/ , 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 losses. As no interventions had been implemented, the weight loss could not be determined to be unavoidable. This represents actual harm to resident #320. | 2020-09-01 |