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Based on record reviews and interviews, the hospital failed to ensure the RN supervised and evaluated the care of each patient. This deficient practice was evidenced by failure of the RN to notify a physician of a significant weight loss for 1 (#5) out of 5 (#1, #2, #3, #4, and #5) patients reviewed for weight loss. Findings:

Review of the hospital's policy titled, Scope of Services Nursing, revealed in part, patients are to be weighed on admit and weekly (unless otherwise specified by MD). Weigh patient on admit and every Sunday morning and assess weight. If the patient weight reflects a loss or gain of 5 or more pounds; have RN re-weigh the patient to confirm the weight loss or gain, once confirmed then; report findings to MD immediately. Assess patient for signs of edema, increase or decrease in appetite, and/or medication which might affect appetite, document notification to MD, Document date and time of notification of MD, receive physician orders, document date and time of receipt of physician orders, follow-up assessment of patient's weight on a weekly basis or as directed by physician orders; document follow-up of patient re-assessment; if physician writes no significant findings on his progress note, please document this on the MDPNs, document date and time of follow-up patient reassessment.

Review of the medical record revealed the patient was admitted on 05/21/2021 with the diagnosis of Dementia with behavioral disturbance. With further review of the patient's medical record revealed the patient's weight on admission on 05/21/2021 was 180.4 pounds, on 05/30/2021 was 174.7 pounds and on 06/06/2021 the patient's weight was 162.6 pounds. This was a weight loss of 17.8 pounds.

An interview was conducted with S3ADON on 07/16/2021 at 10:00 a.m. She reported with review of the EMR she could not find documentation the physician was notified of the patient's weight loss.