JONESVILLE, LA - State health inspectors documented multiple serious care failures at The Columns Rehabilitation and Healthcare Center, including a resident with Alzheimer's disease who lost 14 pounds over three months while staff repeatedly failed to provide physician-ordered nutritional supplements and falsified documentation about her food intake.
Critical Weight Loss Goes Unaddressed Despite Clear Warning Signs
A 69-year-old female resident with severe cognitive impairment experienced dangerous weight loss between February and May 2025, dropping from 137.5 pounds to just 123.2 pounds - a loss of more than 10% of her body weight. The resident, who had Alzheimer's disease and required assistance with meals, repeatedly went without the nutritional supplements her doctor had ordered, while staff members documented that she was eating 76-100% of her meals when observations showed she had barely touched her food.
Medical records showed the resident's weight began declining sharply in April, with an 8-pound loss in just one month between April and May. Weight loss of this magnitude in elderly residents, particularly those with dementia, significantly increases the risk of pressure ulcers, infections, muscle wasting, and accelerated cognitive decline. For individuals with Alzheimer's disease, maintaining adequate nutrition becomes increasingly challenging as the disease progresses, making proper nutritional support essential for preserving quality of life and preventing complications.
During multiple meal observations by state inspectors, the resident was observed sitting in the dining room with untouched food on her tray. Staff members failed to provide the setup assistance she required - such as removing plate covers, opening beverage containers, and arranging utensils - and did not offer encouragement or cueing that her care plan specified she needed. Despite clear documentation that she required these interventions due to her cognitive impairment, certified nursing assistants (CNAs) were observed removing her trays without checking whether she had eaten or providing any assistance.
Falsified Documentation Conceals Nutritional Crisis
The documentation failures revealed a systematic breakdown in care coordination. On May 12, a CNA documented that the resident had consumed 76-100% of her lunch, when inspectors had observed her sitting with an untouched entree and noted she had not been provided the prescribed Mighty Shake supplement. The next day, another CNA documented 51-75% breakfast intake and 76-100% lunch intake, despite inspectors observing unopened food items and the resident not eating during both meals.
When interviewed, staff members demonstrated confusion about the resident's needs. One CNA stated the resident was "independent with eating but requires meal set up," while failing to provide that setup assistance. Another confirmed that CNAs were responsible for notifying nurses when residents didn't eat, but this notification system had clearly broken down. The facility's clinical support nurse acknowledged that "weight loss was not identified until it became significant," indicating a failure in the monitoring systems designed to catch nutritional problems early.
The physician had ordered Mighty Shakes or Magic Cup supplements three times daily with meals on May 9, after speech therapy evaluated the resident and identified swallowing difficulties. However, observations on May 12, 13, and 14 showed the supplements were frequently not provided. When they were provided, staff did not ensure the resident consumed them or document accurately whether she had received them.
Expired Medical Supplies and Loose Pills Found in Medication Carts
Beyond the nutritional care failures, inspectors discovered concerning medication storage violations that posed risks to all residents. During a review of medication carts, inspectors found loose, unidentified tablets in the bottom drawer of one cart - a serious safety hazard that could lead to medication errors if these unknown pills were inadvertently given to residents.
A second medication cart contained multiple expired medical supplies, some dating back several years. Inspectors documented 17 packages of lubricating jelly that had expired in March 2019 - more than six years before the inspection - along with skin protectant creams expired since September 2024 and other supplies with expiration dates ranging from 2022 to 2024. Using expired medical supplies can lead to infections, skin irritation, and treatment failures, as products may lose their effectiveness or become contaminated over time.
The presence of expired supplies for such extended periods indicates a failure in the facility's quality control systems. Professional standards require regular inventory checks and immediate removal of expired products from active stock. The facility's own policy mandated safe storage of all drugs and biologicals consistent with professional standards, yet staff had allowed these expired items to remain in active medication carts where they could potentially be used on residents.
Kitchen Fails to Follow Recipes for Residents Requiring Special Diets
Inspectors also identified problems in the facility's dietary services that affected all 10 residents requiring pureed diets. During kitchen observations, staff were seen preparing pureed lima beans using only 12 ounces of beans when the recipe called for 40 ounces to serve 10 residents - less than one-third of the required amount. This shortage meant residents on pureed diets were receiving significantly smaller portions than intended, potentially contributing to inadequate caloric intake.
For residents with swallowing difficulties who require pureed diets, proper portion sizes are critical for meeting nutritional needs. These residents often struggle to consume adequate calories due to the texture modifications required for safety, making it essential that pureed foods maintain their full nutritional value through proper preparation. When recipes are not followed correctly, vulnerable residents may receive insufficient calories and nutrients, contributing to weight loss and malnutrition.
The dietary manager confirmed during the inspection that staff "did not follow the recipe and did not put enough lima beans in the blender to puree, but should have." This admission revealed a lack of training or oversight in the kitchen operations that could affect the nutritional status of the facility's most vulnerable residents.
Additional Issues Identified
Inspectors documented several other food safety violations in the kitchen area. A serving scoop was found lying directly on top of sugar in a bulk storage container, creating a contamination risk. Additionally, an open package of fish breading was discovered in the pantry exposed to air, violating food storage standards designed to prevent contamination and maintain food quality.
The facility's Director of Nursing acknowledged multiple care failures during the inspection, confirming that the resident with weight loss had not received nutritional supplements as ordered, that meal intake documentation was inaccurate, and that the resident should have received assistance and encouragement during meals. These admissions underscore the systemic nature of the problems identified during the inspection.
The violations documented at The Columns Rehabilitation and Healthcare Center represent fundamental breakdowns in basic care processes. When facilities fail to provide ordered nutritional supplements, accurately document food intake, properly store medications, and follow dietary preparation standards, they place residents at risk for serious health complications. For elderly residents with cognitive impairment who cannot advocate for themselves, these failures can have devastating consequences on their health and quality of life.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Columns Community Care Center ( the ) from 2025-05-14 including all violations, facility responses, and corrective action plans.
💬 Join the Discussion
Comments are moderated. Please keep discussions respectful and relevant to nursing home care quality.