Pulaski Health Care: Missing Meal Records - IN
The resident, identified as Resident C in inspection records, was severely cognitively impaired and completely dependent on staff for eating and drinking. Their physician had ordered daily documentation of every meal and snack consumed, recognizing the critical importance of nutrition monitoring for someone with their complex medical conditions.
Those orders were clear and comprehensive. Chart morning snack intake daily. Chart afternoon snack intake daily. Chart evening snack daily at bedtime. Chart breakfast intake daily. Chart lunch intake daily. Chart dinner intake daily.
The facility's Task Meal Consumption Logs were supposed to document the percentage of snacks and meals eaten. Instead, inspectors discovered a pattern of missing entries that spanned weeks.
Morning snack documentation was absent on twelve separate days between July 22 and August 17. The gaps weren't random - they included consecutive days in late July and early August when no one recorded whether this vulnerable resident had consumed their prescribed nutrition.
Afternoon snack records showed even more extensive failures. Twenty-three days lacked any documentation between July 19 and August 19. The missing entries stretched across nearly every day of the final week of July and continued sporadically through mid-August.
Evening snack documentation disappeared entirely on August 7. Breakfast records vanished on July 22, July 24, and August 8. Lunch documentation went missing on July 25, August 8, and August 10. Dinner records were absent on July 19, July 20, July 23, and August 18.
The resident's care plan, dated March 20 and revised August 18, specifically noted they required a mechanically altered diet texture due to their Lewy body dementia. An intervention included monitoring and recording intakes - the very documentation that repeatedly went missing.
Lewy body dementia affects the brain's ability to control movement and thinking. Combined with Parkinson's disease, the resident faced significant challenges with basic functions like swallowing and eating. Their severe cognitive impairment meant they couldn't advocate for themselves or report problems with their nutrition.
The June 5 Quarterly Minimum Data Set assessment had already flagged the resident's severe cognitive impairment and complete dependence on staff for eating and drinking. This made the missing meal documentation even more concerning, as staff were the only protection between the resident and potential malnutrition or dehydration.
When inspectors interviewed the Administrator on August 21 at 3:25 p.m., they made the administrator aware of the missing documentation. The administrator provided no additional information to explain the gaps.
The Director of Nursing couldn't help either. During an interview on August 20 at 3:59 p.m., the DON indicated she was unable to provide any documentation that the resident's meal consumption logs were completed on any of the missing dates.
The violation extended beyond just this one resident. Inspectors found breakfast documentation missing on eleven separate days in August across the facility. Lunch records disappeared on ten days. Dinner documentation vanished on sixteen different days during the same period.
The systematic nature of the missing records suggested problems with the facility's documentation systems rather than isolated oversights. When residents depend entirely on staff for basic nutrition and their physicians specifically order daily intake monitoring, those records become a critical safety net.
For Resident C, the missing documentation meant weeks when no one officially tracked whether they received adequate nutrition. Their Parkinson's disease and Lewy body dementia already put them at risk for swallowing difficulties and nutritional problems. The absent meal records eliminated the facility's ability to identify patterns or respond to declining intake.
The citation related to a specific complaint numbered 1759620, suggesting someone had raised concerns about meal documentation practices at the facility. Federal inspectors classified the violation as minimal harm or potential for actual harm, affecting few residents.
But for a resident who cannot speak for themselves and depends entirely on staff vigilance for survival, even one day of missing documentation represents a gap in their protection. Thirty days of sporadic record-keeping transforms that gap into a chasm.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Pulaski Health Care Center from 2025-08-22 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 20, 2026 · Our methodology
PULASKI HEALTH CARE CENTER in WINAMAC, IN was cited for violations during a health inspection on August 22, 2025.
The resident, identified as Resident C in inspection records, was severely cognitively impaired and completely dependent on staff for eating and drinking.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.