Failure to Follow Physician Order for Diet Consistency
Penalty
Summary
A resident with a history of an open wound of the left cheek and temporomandibular area, resulting in limited jaw movement, was admitted to the facility and initially placed on a pureed texture diet. Despite a speech therapy evaluation recommending a regular texture (chopped meat) diet and a physician order specifying a regular, no added salt, regular texture, thin liquid consistency diet, the resident continued to receive a pureed diet. The resident reported consuming only 25% of meals and expressed dissatisfaction, stating he should be receiving a regular diet as per his previous habits at home. The deficiency was identified when it was observed that the facility failed to update the resident's diet in accordance with the physician's order and the speech therapy recommendation. The DON confirmed that the resident should have been on a regular textured, thin liquid consistency diet following the speech therapy evaluation. The facility's policy requires that individual dining and food preferences be identified and that meal plans be adjusted after consultation with the resident, but this was not followed, resulting in the resident not receiving the appropriate diet for a period of time.