Failure to Provide Adequate Vegetarian Diets
Penalty
Summary
The facility failed to provide a vegetarian menu for four residents who had physician orders or documented preferences for vegetarian diets. Observations and interviews revealed that the facility did not offer a dedicated vegetarian menu and instead substituted fruit and cottage cheese plates for residents avoiding animal products. Review of meal tickets and medical records confirmed that these residents had ongoing orders or preferences for vegetarian diets, some dating back several months or years. During multiple meal observations, residents on vegetarian diets were served meals that lacked adequate protein and calories compared to the regular menu, with one resident receiving only pureed vegetables and another receiving only fruit, cottage cheese, crackers, and a cookie bar. Staff interviews indicated a lack of understanding and implementation of vegetarian diet requirements, with dietary staff and CNAs confirming that fruit and cottage cheese were routinely substituted for main entrees containing meat. The Registered Dietitian acknowledged that these substitutions did not meet the nutritional needs provided by the regular menu and noted that a vegetarian option was available through the menu company but was not being utilized. Facility policy documents and state law require the provision of balanced vegetarian or plant-based meals, but these were not being followed, resulting in residents receiving nutritionally inadequate meals.