Failure to Update Diabetic Diet Terminology to Meet Professional Standards
Penalty
Summary
The facility failed to ensure that services provided met professional standards of quality by not following the current diet manual recommendations for diabetic diets. Specifically, the facility continued to use the term "RCS" (Reduced Concentrated Sweets) for diabetic diets, despite guidance from the Academy of Nutrition and Dietetics and the American Diabetes Association indicating that such terminology is outdated and not reflective of current nutrition recommendations. The facility's diet manual, menus, tray cards, and dietary documentation all used the RCS nomenclature, and the Registered Dietitian (RD) confirmed that this terminology was used interchangeably with the Consistent Carbohydrate (CC) diet, even though RCS is not a recognized diet by professional organizations. Interviews with the RD revealed that she was aware of the discrepancy between the terminology used at the facility and current professional standards but had not communicated her concerns to the Corporate RD. The RD stated that the facility had always used the RCS terminology for diabetic diets and continued to do so after the implementation of their electronic health record system. The RD also confirmed that she was responsible for the nutrition care plans of all residents on these diets and that the care plans reflected the diet as ordered, using the RCS terminology. A review of facility records showed that 51 residents were receiving an RCS diet, with various modifications such as fortified, high protein, or renal adjustments. One resident with diabetes and a recent fracture was specifically noted to have an RCS NAS regular consistency diet ordered by the physician, and the RD confirmed that this was documented in the care plan and dietary records. The Director of Nursing (DON) also verified that the RCS nomenclature was used because it had been the facility's longstanding practice.