cms_ID: 33
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 33 | BINGHAM MEMORIAL SKILLED NURSING & REHABILITATION | 135007 | 98 POPLAR STREET | BLACKFOOT | ID | 83221 | 2016-06-17 | 242 | D | 0 | 1 | J25411 | **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, review of Resident Council meeting minutes, review of an inservice record, and resident and staff interview, it was determined the facility failed to ensure 1 of 20 sampled residents (Resident #8), and 2 of 7 residents in the group meeting, were allowed to make choices regarding foods and condiments. This resulted in Resident #8, who was on a therapeutic diet, not being served foods she selected and wanted to eat, creating dissatisfaction. It also resulted in frustration of members of the resident group due to lack of response from the facility to their concerns. Findings include: 1. Resident #8 was admitted to the facility on [DATE], for rehabilitation following a fall at home. [DIAGNOSES REDACTED]. Review of the admission MDS assessment, dated 5/6/16, indicated Resident #8 was understood by others and could understand others, had no behavioral indicators; however, was depressed, tired and having a poor appetite. The MDS assessment documented Resident #8 as being on a therapeutic diet with an initial weight of 216 pounds (lbs). Review of Resident #8's care plan, dated 5/6/16, identified the problem of I have potential altered nutrition related to my vitamin deficiency, chronic pain, and reflux. The goal was defined as I will maintain nutritional status through my next review date. One of the care plan approaches documented, I need a therapeutic cardiac, regular texture, thin liquid diet for meals. Review of the Resident #8's initial admission orders [REDACTED]. The plan of care notes, dated 5/6/16, stated, Meal intakes of cardiac, regular texture diet are fair at 50-75% due to the food being 'bland' per (Resident #8). Therapeutic menu extensions were provided for the week of the survey. Review of the cardiac diet menus showed: omission of high sodium meats such as bacon, ham, and sausage for breakfast, 1% milk was served versus 2%, substitution of whole wheat bread for bread, low salt gravies and sauces, low salt soups, low salt grains (rice pilaf, whipped potatoes, risotto, Mexican rice), low salt meats (low salt chicken taco without cheese, low salt spaghetti with meatballs, low salt baked fish) for regular items, and half portions of some desserts were served (pudding, shortcake). Resident #8 was interviewed on 6/13/16 at 12:46 pm. She stated she was admitted to the facility for rehabilitation and was working to improve strength so she could return home. She stated she was prescribed a cardiac diet when she was admitted to the facility and she did not want to be on this diet. She stated she had not been on a therapeutic diet prior to admission to the facility. Resident #8 stated the food was bland, had no flavor and tasted, Like hell. Resident #8 stated she was provided with a written menu ahead of time that she could select from. She stated she frequently selected foods that she did not receive and was told by staff that she could not have them due to her diet restriction. She stated she recently selected pizza from the menu but was not allowed to have it; selected Mexican rice on 6/12/16 but was served plain rice instead, and was recently served plain noodles. Resident #8 stated she did not understand why there were foods listed on the menu for her to select from that she was not allowed to have. Observations during the survey noted salt, pepper, Mrs. Dash, and/or other seasonings or condiments were not available on the tables in the dining room, including on Resident #8's table. On 6/14/16, Resident #8 was observed eating lunch at 12:48 pm. She stated she was not served the tomato juice she ordered on her menu, but was served grape juice instead. Resident #8's menu was on the table and tomato juice was circled indicating her selection. Grape juice was not selected on the menu. The DNS was interviewed on 6/16/16 at 5:50 pm, and stated staff served foods to Resident #8 according to her therapeutic diet parameters. She stated staff met with Resident #8 on 5/4/16 and encouraged the use of Mrs. Dash (herb based seasoning without salt) for added flavor. The Dietitian was interviewed on 6/15/16 at 9:40 am, and verified salt and pepper were not put on the tables customarily at meals. She stated residents could ask for salt if they wanted it. She stated Resident #8 should be served the foods she selected from the menu that included allowable cardiac diet choices. The Dietitian stated Resident #8 had informed her of the diet being bland and that she did not want to be on the diet. The Dietitian was informed of Resident #8's selection of tomato juice, circled on her menu at lunch, and the resident being served grape juice instead. The dietitian stated Resident #8 should have been served low sodium tomato juice. The Director of Nutrition services was interviewed on 6/16/16 at 11:15 am, and stated the facility used to provide salt and pepper shakers on the tables. She stated the previous administrator instructed staff to remove the salt and pepper shakers to prevent residents that should not have sodium from accessing it. his practice had continued since that time. She further stated therapeutic diets were identified in the dietary software and tray cards with this information were printed prior to the meal. She stated dietary staff referred to the tray cards when serving and nursing served the beverages. The Practice Paper: Individualize Nutrition Approaches for Older Adults in Health Care Communities Volume 110, Issue 10, Pages 1554-1563, (MONTH) 2010, include, It is the position of the Academy of Nutrition and Dietetics (formerly the American Dietetic Association) that the quality of life and nutritional status of older adults residing in health care communities can be enhanced by individualization to less-restrictive diets. Resident #8's food choices were not honored and respected. 2. On 6/15/16 at 10:20 am, the group of residents stated meal service took too long and they did not understand why staff stood around the tray line waiting for trays. They stated that although they liked being able to go to the tray line to pick their meal, the process took too long. The group further stated they usually had to ask or wait for their meals to get something to drink. The group stated water was not served unless asked for, as well as, condiments. The group stated that not all the residents were able to eat what they wanted. If a resident was on a special diet, they could not get anything not on the diet especially if they were not able to voice their wishes. The group further stated fluids were not always offered in a glass or cups. They usually got drinks from a can. Resident Council Grievance meeting minutes from the last three months documented the following: * Review of (MONTH) Concerns - Meal service changed to improve flow and timing of meals and hall trays delivered before dining rooms and staff are unable to address residents' special needs or provide extra assistance due to being so busy. * (MONTH) - Residents need assistance in the rehab dining rooms during meals and in completing menus; too much Mexican food on menus; potatoes and fruit too hard. *April - Salt and pepper over used in vegetables and gravies; potatoes under cooked; and meat overcooked and tough; meals cold in dining room; requests for smaller portions not provided; and drinks are not served timely at dinner meals. *May - Staff continue to turn off call lights without providing care. They say they will return but often forget. Staff also need to be quicker in answering the red bathroom call lights. Staff are not helping as efficiently in the dining room during tray line as they could be. A Mini Inservice for staff, dated 5/10/16, documented that residents' continue to report drinks are not served timely at the dinner meal in the dining room. Residents are stating there are times they receive their meal and have yet to be served anything to drink. This concern has been expressed during several resident council meetings. The inservice directed that all residents should receive water, as well as, beverages of choice. The inservice stated CNA are responsible to serve beverages at dinner meals and for staff to be aware of who is in the dining room to ensure drinks are passed prior to meal service. | 2020-09-01 |