Failure to Follow Approved Menu and Portion Sizes for Special Diets
Penalty
Summary
The facility failed to follow its approved daily menu for multiple residents on special diets, as observed during meal service on two consecutive days. Specifically, for residents on puree diets, the cook served only 1/2 cup of lasagna using a #8 scoop, instead of the required 1 cup portion as indicated on the menu. For residents ordered large portions, the cook served 1 1/2 servings of lasagna instead of the correct menu portion of 1 serving of lasagna and 1 1/2 slices of garlic bread. For residents on mechanical soft diets, the cook used a #16 scoop (1/4 cup) to serve roast turkey, rather than the required #10 scoop (3/8 cup) as specified by the menu. These actions were confirmed through trayline observations and staff interviews, where both the cooks and the Dietary Service Supervisor acknowledged the menu was not followed. The deficiencies affected 18 out of 55 medically compromised residents who required puree, large portion, or mechanical soft diets. The facility's own policy and procedure on food preparation requires the use of approved recipes and standardized portions to meet the nutritional needs of residents. The Registered Dietician and Dietary Service Supervisor both stated that the expectation was for menu portions to be followed, and recognized that a review of portion sizes with the cooks might be necessary. The failure to adhere to the prescribed menu portions had the potential to compromise the nutritional status of these residents.