Failure to Provide Appropriate Vegetarian and Texture-Modified Diet
Penalty
Summary
The facility failed to follow standardized recipes and provide appropriate menu options for a resident who required both a vegetarian and minced and moist diet. On the observed lunch service, the cook did not prepare a vegetarian protein alternative for the resident, instead serving steamed carrots as a replacement for fish. The carrots were chopped rather than prepared to the required minced and moist texture, and the resident's meal ticket clearly indicated the need for a vegetarian, minced and moist diet. During the meal, the resident did not consume the chopped carrots, and staff had to mash them further and mix with soup to make them edible. Further observations revealed that the dietary supervisor was unaware of the vegetarian menu requirements for that day and did not notice the improper texture of the carrots served. The following day, the resident was served minced and moist shrimp, which was not appropriate for a vegetarian diet, and the shrimp was noted to be too dry and not minced finely enough. The speech therapist assisting the resident expressed concerns about the food's moisture and texture, and noted the resident's increased risk for aspiration due to posture and swallowing difficulties. The resident's medical history included Parkinson's Disease, dysphagia, and abnormal posture, with documented risks for choking, aspiration, and weight loss. Facility policies required that menus be revised based on resident preferences and that texture-modified diets be prepared as prescribed, with minced and moist foods meeting specific consistency standards. These requirements were not met for the resident in question, as evidenced by the observations and interviews conducted during the survey.