Failure to Follow Standardized Recipes for Therapeutic Diets
Penalty
Summary
The facility failed to follow the prescribed menu and standardized recipes for residents requiring therapeutic diets, specifically for those on consistent carbohydrate (CCHO) and renal diets. On the date in question, a cook did not follow the recipe for gravy intended for residents on these diets, instead preparing it by guessing the ingredients and using turkey juice, flour, and seasonings. The standardized recipe, which was not followed, did not include turkey juice and specified precise amounts of salt and Worcestershire sauce. The cook stated the recipe was not available in the binder and admitted to not following it, while the dietary supervisor confirmed that all food should be prepared using standardized recipes to ensure nutritional adequacy. A resident with significant medical conditions, including type 2 diabetes, end stage renal disease, and hypertensive chronic kidney disease, reported that the food served was too salty despite being on a special diet. Review of the resident's records confirmed orders for a renal diabetic diet with regular texture. During a test tray evaluation, both the dietary supervisor and assistant supervisor noted that the gravy served was salty, which is inappropriate for a renal diet. The assistant supervisor suggested that the amount of base used may have contributed to the saltiness, and both supervisors emphasized the importance of following recipes to ensure residents receive the correct nutrition and palatable food. Further review of facility policies indicated that all meals should meet the nutritional requirements set by national standards and that standardized recipes must be used for all food preparation, with specific modifications for therapeutic diets. The product specification for the turkey used in all diets already included added salt, making adherence to the recipe even more critical. The failure to follow the menu and recipes as required resulted in the potential for residents, particularly those on restricted diets, to receive food that did not meet their nutritional needs.