Failure to Provide Palatable and Properly Tempered Meals
Penalty
Summary
The facility failed to provide palatable, attractive, and appropriately tempered meals to all five sampled residents, as required by its own Food and Nutrition Services policy. Multiple residents with good cognitive status reported that the food was unappetizing, often cold, overcooked, and contained an unpleasant, pervasive spice. Observations confirmed that residents grimaced and declined to eat meals due to these issues, and staff acknowledged ongoing concerns with food quality, including tough meats and repetitive menu items such as rice. Resident Council meeting notes and suggestion forms documented repeated complaints about cold food and inadequate meal temperatures. The facility attempted to address these concerns by repairing equipment and implementing time logs for meal delivery, but interviews and records indicated that these measures were not fully effective. Residents continued to express dissatisfaction with food temperature and quality, and some reported simply not eating disliked items without informing staff. Record reviews and interviews with dietary staff revealed significant lapses in monitoring and documentation. Food temperature logs were incomplete or missing for multiple meals over several days, and cart audit logs were not consistently filled out by staff, making it impossible to determine whether cold food resulted from dietary preparation or delayed tray delivery. The Dietary Manager admitted to insufficient training on temperature log procedures and acknowledged a shortage of warming pellets, further contributing to the problem.