cms_GU: 100
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 100 | GUAM MEMORIAL HOSPITAL AUTHORITY | 655000 | 499 NORTH SABANA DRIVE | BARRIGADA | GU | 96913 | 2010-09-17 | 312 | D | 0 | 1 | 7DPX11 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility did not ensure that a resident who was unable to carry out activities of daily living received the necessary services to maintain good nutrition. Findings include: 1. Resident 3 was admitted to the facility on [DATE] with several [DIAGNOSES REDACTED]. Review of the medical record revealed that the resident was admitted from the hospital where she was treated for [REDACTED]. The minimum data set ((MDS) dated [DATE] described the resident as having short-term memory problem, with moderately impaired cognitive skills for decision-making, and was dependent on staff for all activities of daily living (ADL) including eating. Review of the care plan dated 8/15/10 pertaining to "Imbalanced nutrition--less than body requirements" revealed several interventions including "do not hurry patient" when eating; that Resident 3's "head is flexed slightly forward" and that "if not contraindicated, position patient in a chair or elevate head of bed as high as possible." During several meal observations including lunch on 9/15/10 and dinner on 9/16/10, Resident 3 was observed in bed sleeping while her meal tray was at the bedside on the overbed table. Once the tray was delivered, staff were observed setting up the tray and then leave the room to attend to other tasks. On 9/15/10. for example, Resident 3's meal tray was served at 12:15 p.m. while she was sleeping in bed. On one occasion, a staff was observed in the room and asked if the resident wanted to eat. Getting no response, the staff left the room. At 12:40 p.m.. a dietary staff was observed removing the tray which was largely uneaten from the resident's room. When asked how much the resident ate, the staff stated that the resident "refused to eat." During dinner observation at 5:10 p.m. on 9/16/10, an unlicensed staff was observed feeding Resident 3 who was hardly awake in bed. While encouraging the resident to eat and waking her up, the staff however was observed leaving the room every now and then to attend to other residents. At 5:40 p.m. the resident's tray was removed when the staff determined that the resident was no longer going to eat. In these two instances, staff were not observed to implement care plan interventions to help Resident 3 eat. She was not repositioned, assisted to a chair, or given sufficient time to eat. 2. Resident 7 was admitted to the facility on [DATE] with several [DIAGNOSES REDACTED]. Nursing admission notes dated 9/05/10 described Resident 7 as "alert and oriented (times) 2" and that she was "verbally responsive but confused." A nutritional assessment dated [DATE] described Resident 7 as requiring feeding assistance. During lunch and dinner observations on 9/16/10, facility staff were observed setting up the meal tray for Resident 7 as soon as it was served. Thereafter, staff would leave the room and return later to check on the resident's progress. During lunch meal observation on 9/16/10, a facility staff was observed feeding the resident but stopped when the resident refused to eat further. Staff were not observed to reposition the resident to facilitate eating or encourage or take time to assist the resident. When the tray was removed, it was largely uneaten. Review of nurses notes including on 9/07/10 revealed that "patient did not eat much." On 9/14/10, Patient 7 was noted to "only ate 10%." Review of the medical record revealed that while care plans were available for constipation and "Dehydration due to fluid maintenance," there was no documentation that a care plan was developed outlining interventions and strategies to ensure that Resident 7 had sufficient meal intake and prevent unplanned weight loss. The same nutritional assessment dated [DATE] noted that Resident 7 triggered care planning for "nutrition and dehydration due to (potential) for inadequate calorie and protein intake (related to) dementia, decreased inability to self-feed." During an interview on 9/17/10, a dietary staff stated that residents who required assistance with eating could be referred to rehab services where staff could assist and supervised them through their meals in the dining room. When asked if Residents 3 and 7 were referred and when the referral was made, the dietary staff stated that referrals were made verbally and not documented. During the survey Residents 3 and 7 were not observed participating in any assisted or supervised feeding program or transported out of their room to the dining room. | 2014-12-01 |