In an April, 2012 deficiency survey, the Department of Health found that Hebrew Home of Westchester, a Valhalla nursing home, failed to promote an environment in which residents maintained nutritional status. According to the CFR, a facility must ensure that residents maintain acceptable body weight and protein levels unless his or her condition precludes this. Additionally, the nursing home must provide a therapeutic diet in the case of a resident with nutritional problems. 42 CFR 483.25(i).
The report documents unexplained weight loss experienced by two residents. In the first case, the patient’s weight declined almost eighteen pounds over a seven month period. In the midst of this weight loss, a nutritionist recommended considering adding a health shake to the resident’s diet to stabilize her weight, however nothing in the resident’s record indicates that this shake was provided. The second resident lost over forty-two pounds in just over a month, with no documentation of the staff attempting to ascertain the cause or causes of the loss. Additionally, although the nursing staff noticed that the resident was eating at most half of her food during mealtime, the DOH found no evidence that this diminished appetite was reported to a nutritionist or diet technician.
In both of these residents’ cases, the facility failed to meet either requirement of the regulation discussed above. Without determining the cause of the residents’ weight loss, it cannot be said that either of their conditions demonstrated that maintaining their individual nutritional statuses was not possible. Further, without reporting the weight loss to a nutritionist, or following the advice of the nutritionist, the nursing home did not provide the required therapeutic diet.
Additional deficiencies, as well as further details of these two residents, can be found in the DOH certification survey here.