Delayed Meal Service in Dementia Units
Penalty
Summary
The facility failed to adhere to its meal distribution schedule, resulting in a delay in meal service for residents in the 300 and 400 units, which are secured dementia units. According to the facility's "Tray Service Schedule," lunch was supposed to be served at 12:15 p.m. for the 300 unit and 12:25 p.m. for the 400 unit. However, observations on December 30, 2024, revealed that the meal carts arrived significantly late, with the 300-unit meal cart arriving at 12:57 p.m. and the 400-unit meal cart at 1:05 p.m. The last meal tray was delivered at 1:15 p.m., which was 40 to 42 minutes beyond the scheduled service time. Interviews with staff, including a Registered Nurse and the Dietary Manager, confirmed the delay in meal service. The Dietary Manager acknowledged that the lunch meal preparation started late, which caused the delay in serving the main dining room and subsequently affected the meal delivery to the 300 and 400 units. This delay in meal service was not in compliance with the facility's policy and meal schedule, as meals are expected to be delivered in a timely manner to ensure proper nutrition and care for the residents.
Plan Of Correction
1. There were no adverse affects or issues with the residents meals not being served timely. Dietary staff will be educated on tray time and meal distribution policy by the Dietary Supervisor on January 14, 2025. 2. The Dietary Manager will monitor the tray line to ensure that the tray line starts timely for all meals. 3. Administrator/designee will audit random meals 5 times a week for 4 weeks, weekly for 4 weeks, then monthly ongoing to ensure meal distribution is timely as per meal teams. 4. Findings will be presented to Quality Assurance Performance Improvement Committee for review and recommendations at the monthly meeting.