Failure to Provide Properly Prepared Pureed Diets
Penalty
Summary
The facility failed to provide food prepared in a form designed to meet the individual needs of residents prescribed pureed diets. During meal observation, two residents who required pureed texture diets were served meals with visible lumps in both the entree and vegetables, contrary to their diet orders as indicated on their meal tray cards. A test tray of the pureed entree also contained visible lumps and pieces of red pepper, and the texture was not smooth, requiring chewing, which does not meet the requirements for a pureed diet as outlined by the International Dysphagia Diet Standardization Initiative (IDDSI) and the facility's own recipes. Staff interviews revealed that cooks were aware of the importance of modified textured diets for residents with chewing or swallowing difficulties, but one cook noted unexpected clumping in the pureed rice. The director of nursing and the nursing home administrator acknowledged that while staff had received training on swallowing and dysphagia, it was unclear if this included specific information on IDDSI textures. The quality director was also unsure if all IDDSI resources were integrated into the facility's menu program, despite the facility having used IDDSI diets for about a year.