Brian Center Nursing Home has been cited for allegedly neglecting a resident who rapidly lost weight. The facility did not provide adequate nutrition and failed to determine the cause of this resident’s weight loss.
This resident was admitted with depression, dementia, and type 2 diabetes six years prior to the abuse described in this report. In three months and 17 days, the resident lost 36 pounds, which was 18% of their body weight at that time. The resident weighed 200 pounds on July 10, quickly decreasing in weight until they weighed 164 pounds on October 24.
The resident’s record showed a continuous decrease in weight over these three months, during which the nursing home’s only intervention was to switch the resident from a solid diet to pureed, thin liquids. The nursing home’s Certified Dietary Manager told the state investigator that the resident did not meet the facility’s threshold for “significant” weight loss until three months and three days since they began losing weight.
Just a few days later, the resident was admitted to the hospital due to symptoms of lethargy. After the first day in the hospital, the emergency room (ER) physician reported the facility for alleged abuse to the hospital’s social services, who proceeded to call the state ombudsman. The physician alleged that the nursing home had failed to care for the condition that caused the resident to be admitted to the hospital.
An ombudsman is an advocate certified by the state to visit long term care facilities and ensure that residents are being treated fairly and receiving quality care. These ombudsmen can be staff or volunteer, but all are able to take complaints and work with residents and their families to resolve any issues they may face in a nursing home.
The nursing home’s record did not have any documentation that pertained to the ER physician’s alleged neglect. One of the nursing home’s Licensed Practical Nurses (LPN) stated in an interview with the investigator that the resident had been admitted to the emergency room for lethargy.
The survey team working to compile this report asked for the facility’s full investigative report about the neglect that the ER physician had alleged, but both the Director of Nursing and the Administrator said they were unfamiliar with the issue. The survey team did find that hospital social services notified the state ombudsman and that the facility’s marketing director received a call with this notification. The Director of Nursing and the Administrator were unable to produce “any documentation” about the ER physician’s allegation, including the timeline for these events.
A nursing home is tasked with maintaining each resident’s health and, as much as it is able, to prevent further decline. This means that nursing staff, dietitians, and each resident’s physician work together to create individualized care plans that promote good health for each resident. This nursing home failed to have a plan in place to react to the resident’s rapid weight loss, as the threshold for severe weight loss was hit when they had already lost more than 10% of their original body weight—a significant drop in weight.
In addition to the neglect associated with the resident’s weight loss, the facility also administered doses of an antibiotic beyond what was ordered by a physician and for longer than was ordered. This did not cause additional harm to the resident, but this pattern of incorrect administration for multiple residents shows a poor level of care in this nursing home.
The nursing home was cited for violating three things in this report regarding this resident:
- Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- Report of suspected abuse, neglect, or theft in a timely manner and report the results of the investigation to proper authorities.
- Provide enough food/fluids to maintain a resident’s health.
- Ensure each resident’s drug regimen must be free from unnecessary drugs.
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