CMS Manual System - Louisiana Department of Health and Hospitals

Severity Level 2 Considerations: No Actual Harm with Potential for
more than Minimal Harm that is not Immediate Jeopardy
Level 2 indicates noncompliance that results in a resident outcome of no more than
minimal discomfort and/or has the potential to compromise the resident's ability to
maintain or reach his or her highest practicable level of well being. The potential exists
for greater harm to occur if interventions are not provided.
For Level 2 severity, the resident was at risk for, or has experienced the presence of one
or more outcome(s) (e.g., unplanned weight change, inadequate food/fluid intake,
impairment of anticipated wound healing, functional decline, and/or fluid/electrolyte
imbalance), due to the facility‘s failure to help the resident maintain acceptable
parameters of nutritional status.
Examples of avoidable actual or potential resident outcomes that demonstrate severity at
Level 2 may include, but are not limited to:
Failure to obtain accurate weight(s) and to verify weight(s) as needed;
Poor intake due to the facility‘s intermittent failure to provide required
assistance with eating, however, the resident met identified weight goals;
Failure to provide additional nourishment when ordered for a resident,
however, the resident did not experience significant weight loss; and
Failure to provide a prescribed sodium-restricted therapeutic diet (unless
declined by the resident or the resident‘s representative or not followed by the
resident); however, the resident did not experience medical complications
such as heart failure related to sodium excess.
Severity Level 1: No Actual Harm with Potential for Minimal Harm
The failure of the facility to provide appropriate care and services to maintain
acceptable parameters of nutritional status and minimize negative outcomes
places residents at risk for more than minimal harm. Therefore, Severity
Level 1 does not apply for this regulatory requirement.
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F327
(Rev. 66, Issued: 10-01-10, Effective: 10-01-10 Implementation: 10-01-10)
§483.25(j) Hydration
§483.25(j) Hydration. The facility must provide each resident with sufficient fluid
intake to maintain proper hydration and health