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32 | [CONTINUED FROM LIC 9099] The Complainant claimed that R1 and R2 each lost significant body weight during the approximate three (3) months that these residents lived at the facility, and that facility staff either claimed the residents refused to eat or did not wake the residents up to eat. However, according to regulations, assistance with eating does involve forcing a resident to eat/drink when they are not in the mood.
When R1 moved into the facility in mid-December 2020, their admitting diagnosis was “senile degeneration of the brain.” R1’s hospice nursing assessment said they displayed “clinical evidence of advancing illness” and an “inability to maintain sufficient fluid and caloric intake,” with R1 typically eating only “50-75% of meals.” Over the successive months, visiting hospice nurses noted R1 was generally unhappy about living at a facility (instead of their own home), was sometimes agitated, was increasingly lethargic, and declined many meals offered to them by facility staff. By 03/08/2021, a hospice nurse wrote R1’s nutrition was “very poor” and that R1 “rarely [ate] more than 1/3 of any food offered.” R1 moved out to another care facility on 03/15/2021; yet even in this new setting, R1’s appetite did not improve.
When R2 moved into the facility in mid-December 2020, R2’s terminal diagnosis was “cerebral infarction [aka “stroke”] due to embolism of unspecified cerebral artery.” Their hospice nursing assessment at that time showed R2 was oriented only to themselves, showed fluctuating level of consciousness with periods of “significant lethargy,” was “forgetful and confused,” and their baseline oral intake was “sips and bites.” It also showed R2 “rarely [ate] a complete meal,” that they “generally [ate] only about 1/2 of any food offered,” that they had “inability to maintain hydration and caloric intake,” and that “dysphagia prevents [R2] from receiving enough food/fluid.” Successive hospice visit notes showed R2’s eating skill showed some improvement starting 12/29/2020, but R2’s appetite was still inconsistent; some days R2 refused to eat and spat out their medicines. R2 moved out to another care facility on 03/15/2021; yet even in this new setting, R2’s appetite did not significantly improve.
The Complainant said there was a dramatic decline in R1 and R2’s respective level of alertness and physical functioning during their time living at the facility. However, the Complainant later conceded that they believed facility staff gave R1 and R2 their medications according to how they were prescribed. Hospice care records for R1 or R2 did not suggest a pattern of facility staff deviating from the physician’s medication orders.
[CONTINUED ON LIC 9099-C, 2 of 2] |