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F0803
E

Failure to Follow, Update, and Review Menus by Dietician

San Antonio, Texas Survey Completed on 04-11-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

Dietary staff did not follow the posted menu for a lunch meal, serving pinto beans instead of the scheduled pirogues, without maintaining a substitution log or consulting the dietician about the change. The Food Service Supervisor (FSS) admitted to not posting the monthly menu at a glance, not keeping a substitution log for several months, and making menu changes based on personal assumptions about resident preferences. The FSS also used outdated menus from June 2024, as updated menus were not available or posted, and did not communicate menu changes to the dietician prior to implementation. The facility failed to ensure that the dietician reviewed or approved updated menus for approximately five months, as the updated menus were sent to a sister facility and not obtained by the administrator. The dietician confirmed she had not reviewed or signed the current menus and that dietary staff were using outdated menus without access to menu recipes, substitution options, or purchase guides. Facility policy required dietician approval of menus and adherence to nutritional standards, but these procedures were not followed, affecting the entire resident population.

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