Fresno Postacute Care

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a homelike environment was provided to one of three sampled residents (Resident 1) when her personal belongings were not put away in her room's closet or bedside cabinet, and were left in bags on her bed for over two weeks after moving into the room. This failure had the potential for Resident 1 to feel her environment was temporary and not homelike, and the facility did not care enough about her to place her belongings in the room properly. During a concurrent observation and interview on 7/29/26, at 10:05 a.m., in Resident 1's room, room [ROOM NUMBER], Resident 1 was noted to be in bed surrounded by several bags of her belongings in the bed with her. When asked why her belongings were in bed with her, Resident 1 stated, Where am I supposed to put them? I moved into this room on 7/14/26. Look in my closet. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to have an effective pest control program when three live cockroaches were killed in a 35-minute period in one of one resident rooms (room [ROOM NUMBER]) that had been treated for cockroaches by a pest control company seven days prior. This failure resulted in multiple live cockroaches being observed in a resident room, increasing the risk for bringing and spreading disease-causing germs throughout the facility, despite a recent pest treatment just seven days earlier. During a concurrent interview and observation on 7/29/26, between 10:05 a.m. and 10:40 a.m., in room [ROOM NUMBER], with Resident 1, three live, juvenile cockroaches were noted crawling on the floor. The cockroaches were stepped on and killed during the interview and observation. Resident 1 confirmed that she had seen cockroaches in her room. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to meet professional standards of quality and practices by not following facility's policy and procedures (P&Ps) for four of 19 sampled residents (Residents 32, 64, 59 and 1) and other residents when:1. Resident 32 was administered 5 LPM (liter per minute-a unit of measurement for the flow rate of oxygen) of oxygen therapy (a colorless, tasteless gas essential to living organisms) through a nasal cannula (a thin, flexible tube with two prongs that fit into the nostrils and deliver oxygen) without a physician's order. This failure resulted in Resident 32 receiving oxygen therapy without a physician's order which had the potential to result in shortness of breath, oxygen toxicity (lung damage that happens from breathing in too much extra oxygen therapy), and other serious medical conditions.2. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure drugs and biologicals were stored in accordance with accepted professional standards of practice for one of eight sampled residents (Resident 21) and other residents when: Resident 21 stored over the counter (OTC) medications ( medicines you can get without a prescription) of two jars of expired medicated vapor rub (an OTC medicated topical ointment used to temporarily relieve coughs, nasal congestion, and minor aches/pains using medicated vapors) without physician's order and four colored tablets of Calcium Carbonate (an OTC antacid used to treat heartburn, acid indigestion, and sour stomach) in a medication cup at her bedside table. Resident 21 had no physician's order for self-administration of medications stored at her bedside. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure food was stored, distributed, and served safely when the ice machine was observed with pale pink colored residue on the ice grate (a compartment within the ice machine that determines the size of the ice cubes that are produced). This failure resulted in the facility ice machine not being in a clean safe operating condition which can lead to the growth of microorganisms and result in foodborne illness for 69 out of 70 residents eating ice at the facility. During a concurrent observation and interview on 4/7/26 at 9:06 a.m. with the Maintenance Director (MND), the Kitchen Supervisor (KS), and the Registered Dietician (RD), the ice machine was observed in the kitchen. The MND was observed removing the ice grate cover. A pale pink colored residue was observed at the top of the ice grate. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to follow professional standards of practice to ensure the Care Plan (CP) was reviewed and revised in a timely manner for one of six sampled residents (Resident 6) when the goals for Resident 6 were not reviewed and revised for right and left (bilateral) lower leg edema (swelling) for six months (since October 2025). This failure had the potential for Resident 6 to not receive the appropriate care for his bilateral lower limb edema and put Resident 6 at risk of adverse (harmful) effects from swelling such as skin breakdown, infection, hypertension (when the pressure in the blood vessels is too high), cardiovascular disease (heart disease) and death.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure activities of daily living (Activities of Daily Living (ADLs- routine tasks/activities such as grooming, bathing, dressing and toileting a person performs daily to care for themselves) were not provided for two of eight sampled residents (Resident 79 and 17) when: 1. Resident 79's fingernails were long, jagged (sharp, uneven edges) and dirty with brownish to blackish dirt built up underneath the nails and toenails were long and thick. This failure had potential for Resident 79 in obtaining avoidable skin related injuries (including cuts (laceration), scrapes (abrasion), scratches, etc.) and infection (the invasion and growth of germs in the body).2. Resident 17's beard (the growth of hair on the chin and lower cheeks of a man's face) were silvery thick and long. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure residents received treatment and care in accordance with professional standards of practice when Resident 54 received medication from unauthorized staff and was not monitored and assessed by Licensed Nurses for effective medication and treatment. This failure had the potential for Resident 54 not to receive necessary care, treatment, and services based on comprehensive assessment and comprehensive person-centered care plan. During a concurrent observation and interview on 4/7/26 at 9:46 a.m. with Resident 54, in Resident 54's room, Resident 54 was lying flat on low air loss mattress (a specialized medical surface that combines alternating pressure with a steady, low-volume airflow to treat or prevent pressure ulcers (bedsores) and manage moisture) in his bed. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents' drug regimen must be free from unnecessary drugs for one of eight sampled residents (Resident 21) when Resident 21 was receiving an opioid (or narcotics, are potent substances derived from or mimicking the poppy plant) pain medication (used to treat moderate to severe pain) for excessive duration without adequate indication and monitoring. These failures placed Resident 21 at an increased risk of receiving unnecessary medications and had the potential to experience negative effects such as drug addiction, overdose, and fatal respiratory depression. During a concurrent observation and interview on 4/8/26 at 9:36 a.m. with Resident 21, in Resident 21's room, Resident 21 was self-propelling her wheelchair. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to establish and maintain an effective infection prevention and control program for two of six sampled residents (Resident 4 and Resident 69) when: 1. Resident 4 was not placed on Enhanced Barrier Precautions (EBP - an infection control intervention designed to reduce transmission of resistant organisms [bacteria that have become resistant to certain antibiotics] that requires gown and glove use during high contact resident care activities) for documented Methicillin Resistant Staphylococcus Aureus (MRSA-a type of bacteria that could cause an infection and was harder to treat because some antibiotics [medication used to treat infections] did not work against it). [...]

Inspectors wroteBased on interview and record review the facility failed to designate a Registered Nurse (RN) to serve as the Director of Nursing (DON) on a full-time basis when the facility had no full time DON.This failure had the potential to not to meet the critical needs of high acuity residents (individuals requiring intensive, specialized care, constant monitoring, and frequent medical interventions due to severe or complex health conditions) causing serious injury, harm and impairment. During an interview on 3/19/26 at 2:00 p.m. with the Administrator (ADM), the ADM stated he's been the administrator of the facility for eight days. The ADM stated the facility does not have a DON or an interim (in the meantime, temporary or acting) DON. The ADM stated the facility's current census was 71. During an interview on 3/19/26 at 4:28 p.m. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure professional standards were met when:1) A Licensed Vocational Nurse (LVN 1) failed to accurately complete admission data for one of three sampled residents (Resident 1) when several errors were made when completing Resident 1's new admission assessment. This failure resulted in inaccurate information regarding the fall risks of Resident 1, which had the potential for inaccurate care planning to prevent falls.2) A Licensed Vocational Nurse (LVN 2) failed to wear gloves when applying a cream to the vaginal area of one of three sampled residents (Resident 2). This failure had resulted in loss of dignity and risk of contamination of infectious micro-organisms for Resident 2.1. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure residents were free from neglect when Certified Nursing Assistant (CNA) 9 intentionally did not provide incontinent care (provided for those who cannot control their bowels and/or bladder) for three of five residents (Resident 1, Resident 2, and Resident 3) on 12/21/24 between the hours of 11 p.m. and 7:30 a.m. on 12/22/24. CNA 9 expressly limited incontinent care to one change for Resident 1 and Resident 2 and did not provide care for the entire shift for Resident 3. These failures resulted in withholding of required services and neglecting the needs of Residents 1, 2, and 3. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to meet professional standards of practice for four of eight sampled residents (Resident 8, 38, 2 and 57) when: 1. Registered Nurse (RN) 2 did not follow medication administration direction when she gave medication to Resident 8 without giving food. This failure had the potential to put Resident 8 at risk for stomach upset. 2. A small medication cup with one tablet was left on top of Resident 38's bedside table accessible to other residents. This failure had the potential for Resident 38 to not receive a prescribed medication and for other residents to have access to the medication. 3. Resident 2 and Resident 57's physician order for bed rails was not followed. This failure had the potential to put Resident 2 and Resident 57 at risk for injury which could lead to more serious health condition.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the planned menus were followed for the lunch meal on August 12, 2024 when: 1. Incorrect portion sizes were used on the therapeutic diets: a. ½ cup (4 ounces) of sweet potato fries were served instead of ¼ cup (2 ounces) to 20 residents (Resident 42, 5, 16, 6, 26, 9, 23, 60, 12, 74, 34, 4, 37, 24, 77, 25, 22, 29, 78, and 13) who were on a Consistent Carbohydrate (CCHO) diet (a diet that provides a consistent amount of carbohydrates at each meal and from day to day to help keep blood sugar levels stable); and b. #16 scoop (2 ounces) of roast beef was served instead of #10 scoop (3.2 ounces) to eight residents (Resident 21, 57, 61, 54, 3, 55, 66, and 28) who were on a mechanical soft diet (a diet of soft-textured foods that are easy to chew and swallow); and c. [...]

Inspectors wroteBased on 0bservation, interview, and record review the facility failed to provide a sanitary environment to help prevent the development and transmission of communicable diseases and infections for two of seven residents (Resident 61 and Resident 238) when Certified Nursing Assistant (CNA) 1 did not perform hand hygiene (process of washing or disinfecting hands to prevent the spread of germs) after leaving the shared room of Resident 61 and Resident 238, while carrying a bag of soiled (dirty or contaminated) linen. CNA 1 then moved the linen cart without performing hand hygiene. This failure had the potential to contaminate the surface of the linen cart and cause cross contamination (when germs move from one area to another) of other surfaces.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure residents were treated with dignity and respect for three of nine sampled residents (Resident 20, Resident 24 and Resident 40) when: 1. Registered Nurse (RN) 2 administered medication to Resident 20 in the hallway. 2. RN 1 administered medication to Resident 24 and did not provide privacy. 3. Licensed Vocational Nurse (LVN) 1 administered medications to Resident 40 and did not provide privacy. These failures resulted in Resident 20, Resident 24 and Resident 40 not being provided with respect and dignity while taking their medications.

Inspectors wroteBased observation, interview, and record review the facility failed to ensure four of fourteen residents (Residents 8, 30, 57 and 65) were provided their right to be treated with respect and dignity when: 1. Resident 30's back was not covered after being transported out of the shower room. This failure resulted in Resident 30 having his back exposed while being transported out of the shower room, down the hall, and into his room. 2. Certified Nursing Assistant (CNA) 11 stood over Resident 8 while spoon feeding him breakfast while lying in bed. This failure resulted in Resident 8 not being provided a respectful and dignified dining experience which could further enhance resident's quality of life. 3. Resident 57 was lying flat in bed eating lunch but unable to see food placed on top of the overbed table positioned in front of her. [...]

Inspectors wroteBased on interview, and record review, the facility failed to ensure the Minimum Data Set assessment (MDS-assessment of physical and psychological functions and needs) accurately reflected resident's health and functional status of four of nine sampled residents (Residents' 14, 29, 34 and 38) when Resident 14, Resident 29, Resident 34 and Resident 38's smoking habits was inaccurately coded on the MDS assessment. This failure had the potential to result in Residents' 14, 29, 34 and 38's care needs not met.

Inspectors wroteBased on interview and record review the facility failed to develop and implement a comprehensive person-centered care plan that meets resident preferences for one of seven residents (Resident 66) when Resident 66's preference to be cared for by female staff was not care planned. This failure had the potential to cause male staff members to unknowingly enter Resident 66's room to provide care.

Inspectors wroteFindings: 2. During a concurrent observation and interview on 8/15/24 at 9:45 a.m. with Licensed Vocational Nurse (LVN) 4 in station 2 at medication cart one, two medication bottles of Perampanel (medication used to prevent seizures [rapid, rhythmic, uncontrollable shaking, with muscles contracting and relaxing repeatedly]), with no visible expiration dates. LVN 4 stated she was unable to find a visible expiration date on the label from the pharmacy and the expiration date was not marked on the bottles. LVN 4 stated every medication is to have a visible expiration date, prior to dispensing medication to residents the expiration date is to be reviewed and if the medication is expired it is to be discarded. LVN 4 stated, expired medication could have lost efficacy (desired result) and not give the desired effect or give unwanted side effects to the resident. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure three food service staff (DA 1, DA 2 and [NAME] 1) were competent to carry out the functions of food and nutrition services safely and effectively when they served incorrect portion sizes of food items and did not have a competency or skills check done. This failure had the potential to result in residents' diet orders and facility menus not being followed.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure food was palatable and flavorful when the lunch served for residents had firm and undercooked peas, dry and bland chicken, and bland rice. This failure had the potential to result in residents to have decreased meal intake due to difficulty chewing and eating their food which can lead to resident's not meeting their nutrition needs.

Inspectors wrote3. During a review of Resident 29's admission Record (AR- a document that provides resident contact details, a brief medical history, level of functioning, preferences, and wishes), dated 8/15/24, the AR indicated Resident 29 was admitted with the following diagnoses: diabetes mellitus (A disease which result in too much sugar in the blood), chronic kidney disease (when the kidneys have been damaged over time resulting in decreased function), vitamin D deficiency (vitamin deficiency that causes issues with your bones and muscles), and muscle weakness. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to maintain medical records which were complete, and accurately documented in accordance with accepted professional standards and practices for three of seven residents (Resident 51, Resident 2 and Resident 22) when: 1. Resident 51's name was spelled incorrectly on his Physician Order for Life Sustaining Treatment (POLST- a medical document which outlines a patient's preferences for end-of-life care). This failure resulted in inaccurate medical records being kept for Resident 51 and had the potential to cause confusion to staff who read his POLST form. 2. Resident 2's copy of Physician Orders for Life-Sustaining Treatment (POLST) form was not signed and readily available as part of Resident 2's current medical records. 3. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain an effective pest control program when cockroaches were found in the facility kitchen and hallway. This failure had the potential to result in residents, staff, and visitors to contract diseases caused by pests. The facility census was 75.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide pharmaceutical services which ensured the administration of medication to meet residents needs for one of nine sampled residents (Resident 65) when Resident 65's Ergocalciferol (medication used to prevent and treat Vitamin D deficiency [nutrient the body needs for building and maintaining healthy bones]) was not available for administration for one day on 8/14/24. This failure had the potential for Resident 65 to not received the nutrient her body needs which could lead to serious health condition.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure the facility medication error rate did not exceed five percent (10.34 percent) when: 1. Registered Nurse (RN) 2 administered metformin medication to Resident 8 without food when the medication direction indicated to administer with food. This failure had the potential for Resident 8 to develop upset stomach or gastrointestinal (GI)problems which could lead to more serious health condition. 2. RN 2 did not completely dilute Resident 65's Juven therapeutic powder (brand name [used for wound healing]) before administering to Resident 65 leaving residue of the powder in the bottom of the cup. This failure resulted in Resident 65 not receiving the complete dose which had the potential for slower wound healing and could lead to more serious health condition. 3. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure pureed meat was able to hold its shape or form for seven of 64 sampled residents (Resident 27, 1, 69, 2, 15, 49, and 44). This failure had the potential to result in residents choking or decreased meal intake.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure adaptive equipment was provided for one sampled resident (Resident 3) when Resident 3 was not provided a sippy cup on his meal tray. This failure had the potential to limit Resident 3's ability to drink independently and safely. The facility census was 75.

Inspectors wroteBased on observation and interview, the facility failed to provide the minimum of at least 80 square feet per resident in 17 resident bedrooms (Rooms 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17, 18, 19, 20 and 21) when there were two residents in rooms which did not meet the square footage requirement. This failure had the potential to place residents at risk for not having sufficient space to accommodate residents' needs, privacy, and comfort.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a sanitary, comfortable environment for four of 31 sampled residents (Resident 11, Resident 22, Resident 47 and Resident 60), when the smell of urine was noted in room [ROOM NUMBER] and hallway. This failure had the potential for Resident 11, 22, 47 and 60, to experience an uncomfortable environment.

Inspectors wroteBased on observation, interview and record review, the facility failed to maintain an environment free from accident hazards for one of four sampled residents (Resident 2) when Resident 2 fell out of a lowered bed while she was being changed (changing of resident clothing) by Certified Nurse Assistant (CNA) 1. This failure resulted in skin tear and bruises to Resident 2.

Inspectors wroteBased on interview and record review the facility failed to hire a qualified Dietary Supervisor (DS) with the appropriate competencies and skill sets to carry out the functions of the food and nutrition services for 68 of 74 residents, when the dietary supervisor did not meet the minimum qualifications for the role. This failure resulted in sanitation issues in the kitchen, the menu not being followed for lunch on 8/28/2023 and had the potential to affect the nutrition and health status of medically compromised (easily gets sick) residents who received food from the kitchen. (cross-reference F-tag 812 and 803)

Inspectors wroteBased on observation, interview, and record review, the facility failed to follow the written menu for lunch on August 28, 2023, when: 1. Two residents who were on a small portion diet (Residents 27 and 37) did not receive the correct portion size of the entrée and side dishes. The small portion size diet was served incorrectly. This failure placed Residents 27 and 37 at a potential risk to not receive adequate nutrients. 2. Applesauce was given for dessert for seven residents on a puree diet (Residents 1,2, 5, 15, 17,48, and 58) instead of the puree raspberry parfait square. This failure had the potential for Residents 1,2, 5, 15, 17,48, and 58 to not be satisfied with the dessert and subsequently miss out on those calories provided by the dessert. 3. Seventy-one residents did not receive the zucchini, orange slice or bread roll as it was indicated on the menu on 08/28/23. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure safe preparation, distribution, and storage practices were followed in the kitchen when: 1. Trash, black grime (dirt stuck to the surface of something) and a knife were found underneath the stove. 2. The can opener in the kitchen had black sticky residue and was covered in grime. 3. The shelf above the steam table was dirty. 4. A dead water bug was found in the mop closet. 5. Oven mitts had black grime. 6. Four cooking pans were crusted with black grime. These failures had the potential to attract pests, contaminate residents' food, and cause foodborne illnesses to 68 of 74 sampled residents who receive food from the kitchen.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents were free from unnecessary psychotropic (drugs that affects brain activities associated with mental processes and behavior) medications for three out of three residents (Resident 62, 30, 49) when: 1. Resident 62 was administered quetiapine (an antipsychotic medication given for certain mental disorders and works by altering brain chemistry to help reduce psychotic symptoms) and the facility did not attempt or implement resident specific non-pharmacological interventions, quetiapine dose was increased without clinical justification, and facility did not monitor the use of quetiapine according to manufacturer specifications. 2. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents were free of medication error in excess of five percent or greater whereas the observation of 25 opportunities during the medication pass resulted in four errors (calculated medication error rate of 16%) when: 1. Licensed Vocational Nurse (LVN) 2 did not rotate the insulin (medication used to control high blood sugar) administration site when administering Resident 6's insulin. This failure placed Resident 6 at risk for elevated blood sugar levels. 2. LVN 2 administered Morphine (used to treat pain) IR (Immediate Release- morphine that acts quickly over a short period of time) instead of Morphine ER (Extended Release-morphine that acts over a long period of time). This failure placed Resident 24 at risk for ineffective pain management. 3. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure drugs and biologicals used in the facility were stored and/or labeled in accordance with current accepted professional principles and facility policies and procedures, for 2 of 4 medication carts and 1 of 2 medication rooms when: 1. In the Nursing Station 1 medication room, a punctured 1 milliliter (ml- unit of measure) vial of single dose (Epoetin Alfa brand name - medication which helps the body make more red blood cells) 10,000 units for Resident 73 was observed stored in the medication refrigerator. 2. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to maintain infection prevention and control practices when: 1. Licensed Vocational Nurses (LVN 2 and 4) did not appropriately disinfect (be free of any bacteria or other microorganisms [very small creatures unable to be seen with the naked eye]) the facility's shared glucometer (a device used to measure the amount of sugar in the blood) for three sampled residents (Residents 60, 7 and 43) according to manufacturer instructions for the disinfecting wipes. 2. LVN 4 did not perform hand hygiene prior to providing care to two sampled residents (Resident 60 and 18) during medication pass (the time to hand out medications). These failures had the potential to spread infection to other residents, staff, and visitors.

Inspectors wroteBased on observation and interview, the facility failed to provide the minimum of at least 80 square feet per resident in 17 resident bedrooms (Rooms 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17, 18, 19, 20 and 21) when there were two residents in rooms which did not meet the square footage requirement. This failure had the potential to place residents at risk for not having sufficient space to accommodate residents' needs, privacy, and comfort.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents were treated with dignity and respect for one of three sampled residents (Resident 31) when the family room was locked and inaccessible for resident use. This failure resulted in the violation of Resident 31's rights to use the family room.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the Minimum Data Set (MDS- a resident assessment tool that evaluates memory recall and physical functions and guides care planning decisions) assessment accurately reflected the resident's status for one of nine sampled residents (Resident 67) when Pneumonia (an infection of the lungs that may be caused by bacteria, viruses, or fungi) was listed as a current diagnosis for Resident 67. This failure resulted in an inaccurate assessment of Resident 67's and had the potential to result in Resident 67's care needs going unmet.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure residents were provided an environment that promoted well-being and feeling of self-worth and self-esteem for one of 74 residents (Resident 38) when Resident 38 was eating while lying down. This failure had the potential for Resident 38 to not feel good about himself and his situation of eating while laying down which could lead to eating less of his food and choking.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide care in accordance with professional standards of practice for one of three sampled residents (Resident 55), when Licensed Vocational Nurse (LVN) 7 failed to assess skin integrity after skin tear was reported by Certified Nursing Assistant (CNA) 2. This failure resulted in an unattended skin tear for Resident 55 which had the potential to result in further skin breakdown and infection.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide an appropriate diet to maintain healthy weight for one of 74 sampled residents (Resident 38) when Resident 38 was eating a regular diet with his hands. This failure resulted in Resident 38 losing 11.6% of his body weight in three months (May to July).