Does failure to properly prepare and serve food according to a resident’s specific dietary needs and lack of staff in attendance during meal times indicate that substandard quality of care was provided, creating the possibility of submitting false claims in violation of the False Claims Act? [F725 Sufficient Nursing Staff; F805 Food in Form to Meet Individual Needs; F600 Free from Abuse and Neglect]
Compliance Perspective – Dietary Needs
Policies/Procedures: The Compliance and Ethics Officer, DON, Food Service Director, and the Administrator will review the facility’s policies and procedures regarding provision of adequate staffing to provide care for the residents in the facility, and the protocol for meeting special dietary needs of individual residents.
Training: Dietary staff will be trained regarding the requirement to provide food in the form necessary to meet individual dietary needs. Managers and direct care staff will be trained regarding abuse and neglect and requirements to provide adequate supervision and assistance to residents during meals, even if minimal levels of staff are available.
Audit: An audit will be conducted to determine the number of days and the extent of the failure to meet the required number of staff-care hours. All residents will have their dietary regimen audited to determine if it meets their individual needs. The results of the audits will be compiled, summarized and submitted to the QAPI/QAA Committee for review and recommendation. The Compliance and Ethics Officer will place this topic on the agenda for discussion at the next Compliance and Ethics Committee meeting.
A resident in an Illinois nursing and rehabilitation facility died after choking on a slice of pizza that did not meet the requirements of her diet regimen because it was not cut into small pieces. Staff responded when they noticed the resident was unresponsive and not breathing. They began chest compressions and tried unsuccessfully to remove the food that was lodged in her throat.
An ambulance arrived, and attempts were made unsuccessfully to intubate the resident. EMTs removed the food blocking the resident’s airway and were then able to intubate the resident, but she died.
The nurse providing a report to the Illinois Department of Public Health indicated that the facility was short-staffed, and this made caring for residents at meal time very difficult.
An investigation into the claim regarding insufficient staffing showed that the facility was short-staffed when the incident occurred. The facility is required to have 349 hours of direct staff care per a 24-hour period; however, on the day of the incident there was a shortage in staff hours of 126 hours.
The facility is facing a fine of $25,000 related to the resident’s death.
