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12/5/2007 Survey Tag 0449 Detail for:
RELIANT RENAL CARE RRC TRINIDAD
Wednesday, October 23, 2019 12:19 AM

Survey Date: 12/5/2007

Regulation Number:0449

Regulation Title: DIETITIAN RESPONSIBILITIES

Regulation Description: The dietitian, in consultation with the attending physician, is responsible for assessing the nutritional and dietetic needs for each patient, recommending therapeutic diets, counseling patients and their families on prescribed diets, and monitoring adherence and response to diets.

Surveyor Findings:


Based on medical record review and staff interview, the facility failed to provide adequate dietetic services in 5 (#1, #2, #3, #4 and #5) of five medical records reviewed. This failure created the potential for nutritional and dietetic needs of the patients to go unmet. The findings were:

The medical record for sample patient #1 was reviewed on 12/5/07. The patient was admitted on 3/27/06 for the first hemodialysis treatment. A nutrition assessment was performed six months later on 9/4/06, but no further documentation by a dietitian since 5/07.

The medical record for sample patient #2 was reviewed on 12/5/07. The patient was admitted on 8/31/07 for the first hemodialysis treatment. There was no initial dietary assessment performed.

The medical record for sample patient #3 was reviewed on 12/5/07. The patient was admitted on 6/15/07 for the first hemodialysis treatment. There was no documentation by a dietitian for 6/07 and 8/07.

The medical record for sample patient #4 was reviewed on 12/5/07. The patient was admitted on 3/22/06 for the first hemodialysis treatment. There was no documentation by a dietitian since 5/07.

The medical record for sample patient #5 was reviewed on 12/5/07. The patient was admitted on 10/20/05 for the first hemodialysis treatment. There was no documentation by a dietitian for 5/07, 7/07, 8/07 and 9/07.

The Director of Nursing (DON) was interviewed via telephone on 12/5/07 at 2:30 p.m. The DON stated that the most recent dietitian started working in the facility approximately in 5/07. The dietitian before that had been contracted by the facility. It wasn't clear if the dietitian had specific days that s/he worked in the clinic or whether s/he was called when the laboratory test results were available.

Facility Plan of Correction:

A qualified dietician has been hired as of 12/27/07 with chart review beginning 12/31/07.
Dietetic needs for patients # 1-5 will be reviewed 12/31/07. see attachments All patients will be reviewed by the end of January 2008.

The new dietician will be at the clinic 2-3 times in the Month of January to review and update all charts. She has then contracted to be at the clinic at least one time per month after laboratory results are avaliable and as needed for patients dietary needs.

The policy of Summit Kidney Centers is that all Long term care plans, physicians Standing Orders, Nursing History and Physical, Treatment options, Psycosocial Assessments, Dietiary Assessments and Consent to dialyze forms are to be monitored by the Director of Nursing. This responsiblity may be delegated to the appropriate personnel.

QA at this time states that all charts will be reviewed quarterly. A data base that monitors and flag dates and requirments has been started in the computer, a designated person will monitor and update files. The results will be reported to the DON and upward to the Medical Director



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Colorado Department of Public Health and Environment
Health Facilities and Emergency Medical Services Division
4300 Cherry Creek Drive South
Denver CO 80246-1530
Email us or phone 303.692.2800 main

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