Failure to Follow Prescribed Diets and Standardized Recipes
Penalty
Summary
The facility failed to ensure that menus and food preparation met the prescribed dietary needs of residents, as evidenced by multiple observations and interviews. Dietary staff did not follow standardized recipes when preparing pureed vegetables and meats, instead adding unapproved ingredients such as white bread, and did not refer to the recipes during preparation. The Registered Dietitian confirmed that this practice was not standard and could alter the nutritional content of the food. Additionally, the correct portioning tools were not used for mechanical soft diets, resulting in residents receiving less than the required amount of food. Further deficiencies were observed in the serving of therapeutic diets. A resident on a Consistent Carbohydrate (CCHO) diet was served two tacos instead of the prescribed one, contrary to the dietary spreadsheet and recipe instructions. Residents on renal and heart healthy diets were served inappropriate food items, such as pinto beans and oven-browned potatoes, instead of the specified alternatives like seasoned corn or low salt seasoned rice. These substitutions were not in accordance with the dietary guidelines for those medical conditions, as confirmed by the Registered Dietitians. The facility's own policies and procedures required the use of standardized recipes and adherence to menu guidelines to meet residents' nutritional needs. However, staff failed to follow these protocols, resulting in residents receiving food items and portions that did not align with their physician-ordered diets. These actions were confirmed through direct observation, interviews with dietary staff and Registered Dietitians, and review of facility documentation.