Failure to Accommodate Resident Dietary Preferences
Penalty
Summary
The facility failed to accommodate dietary preferences for two residents as required by its own policy and regulatory standards. The policy states that food preferences should be honored unless contraindicated, and that the Food Service Manager or designee is responsible for interviewing residents to obtain and update their food preferences, which should be reflected on the resident's tray card. However, for both residents reviewed, there was no evidence that their food preferences were properly documented or communicated to dietary staff. One resident, with a history of muscle wasting, chronic pain, and past trauma related to food deprivation, expressed a preference for pancakes and French toast, but these preferences were not discussed in quarterly nutritional reviews or reflected on the tray card. The resident reported not receiving preferred breakfast items and instead received oatmeal, which was not among his stated preferences. Observations confirmed that while pancakes were served to others, the resident did not consistently receive his preferred foods, and his tray card lacked any indication of likes or dislikes. Another resident, with diagnoses including dementia and a history of dehydration, was documented as disliking tea and being at risk for poor oral intake. Despite this, the resident's nutritional assessment was incomplete, and the tray card did not indicate beverage dislikes. The resident was observed to have tea on his tray, which he did not drink. Interviews with the Dietary Manager revealed that food preferences were not consistently documented or accessible to staff preparing trays, and the process for updating and communicating preferences was not followed as outlined in facility policy.