Failure to Provide Meal Alternatives and Accommodate Dietary Restrictions
Penalty
Summary
The facility failed to provide a meal substitute for Resident R97, who requested an alternative meal option. Resident R97, who has moderate cognitive impairment and a diagnosis of malnutrition, did not eat the lunch served and requested a hamburger, which was listed as an alternative option on the 'always available menu.' However, when the Unit Clerk, Employee E17, contacted the kitchen to request the hamburger, the kitchen staff stated they could not provide it and informed that hamburgers would be available the next day. Additionally, the facility did not accommodate Resident R6's dietary needs, who was on a lactose-restricted diet due to multiple sclerosis, chronic obstructive pulmonary disease, and muscle weakness. Despite the dietary orders and care plan specifying a lactose-restricted diet, Resident R6 reported receiving meals containing cheese and milk, which led to loose bowel movements. An observation confirmed that Resident R6 was served cheese on top of chicken, contrary to her dietary restrictions.
Plan Of Correction
1. R97 and R6 were provided with a meal that was in house and met allergies, preference. Hamburgers and hotdogs were taken off the always available menu. Dietitian met with resident R6 to ensure that we have allergies noted and address her restrictions. 2. Always available menu will be adjusted if item is unable to be delivered. Audit to ensure that all residents have dietary restrictions and preferences in place. 3. Education provided to Dietician, and Food Service Employees to ensure that preference, restrictions and allergies are being followed. Education that if a item that is on the always available menu is not able to be kept in stock it must be removed. 4. Random audits by the Administrator/designee of 5 residents to ensure that residents are receiving a meal that meets their needs related to allergens, preferences and restrictions once a week for one month, twice a week for one month and once a month for one month. Random audits of the Always available menu to ensure food is available once a week for one month, twice a week for one month and once a month for one month. The findings of the audits will be brought to the monthly Quality Assurance Improvement Committee (QAPI) meeting monthly for a period of three months. Any revisions to the audit plan will be reviewed and implemented with the coordination of the interdisciplinary team at QAPI Committee meeting.