Complaint Investigation Report

Allegation: Staff did not ensure resident received adequate nourishment, resulting in significant weight loss

It was reported to the department that R1 was not receiving adequate nourishment which caused R1 significant weight loss. Interview with W1 and W2 revealed that R1 lost weight W1 reported that W2 was the one that noticed, one day W2 was at the facility and witnessed R1 shoulder that looked like R1 was smaller, W2 stated that W2 is not sure how R1 had gotten smaller. W2 stated that W2 made sure R1 ate when W2 was at the facility. W2 brought it to the facilities attention and S1 and W2 agreed that the facility would now start to provide R1 with a Ensure Protein shake. S2 stated that R1 was tall and skinny when R1 was admitted to the facility. S2 also stated that R1 would eat 100% of R1’s breakfast and a good amount of R1’s lunch but would eat less dinner some times as low as 30 to 40%. S2 stated that W1 and W2 would visit the facility 3 to 4 days a week at lunch time and would also eat lunch with R1. S3 reported that R1 would always eat 100% of R1’s breakfast, S3 also reported that R1 would often feed R1’s self and on some days staff would feed R1. S3 also reported that R1 had a special diet and the facility staff would follow the physicians orders. S4 stated that the facility dose clean eating, well balanced meals, the facility provided R1 with the protein shakes. S4 stated that the family is very protective and S1 or S4 would contact the family with any changes or incidents that happened with R1. LPA conducted a record review the LIC 602 stated that R1 was on a special diet, the resident’s daily food chart shows that R1 ate 100% of breakfast and 50 to 100% of lunch and 50 to 100% of dinner. Progress notes revealed that R1 was diagnosed with moderate protein calorie malnutrition upon admission. THEREFORE THIS ALLEGATION IS UNSUBSTANTIATED.