Failure to Accommodate Resident Snack Preferences
Penalty
Summary
The facility failed to reasonably accommodate the needs and preferences of a resident by routinely providing only crackers as evening snacks, despite the resident's repeated requests for more substantial alternatives. The resident, a man with diagnoses including anemia, depression, anxiety, chronic pain, gastro-esophageal reflux disease, and stage two chronic kidney disease, had intact cognitive abilities and communicated his dissatisfaction with the limited snack options to both nursing staff and the Dietary Manager. He reported that he consistently received only crackers, with the exception of one occasion when he was given a peanut butter and jelly sandwich, and another when a staff member gave him a personal cookie due to the lack of other options. The resident specifically requested a greater variety of snacks, such as ice cream, popsicles, cookies, sandwiches, or pudding, to address his hunger overnight. The Dietary Manager confirmed that the facility's policy was to provide only saltine crackers, graham crackers, or Goldfish crackers as snacks, with oatmeal creme pies offered only if other options were unavailable. Sandwiches were not routinely stocked for snacks and were only prepared upon specific request from nursing staff. The Dietary Manager acknowledged being aware of the resident's requests for more substantial snacks but had not considered offering alternatives beyond the standard options. The facility's policy indicated that snacks should be provided as identified in individual care plans and that the dietary department should collaborate with residents and staff to identify appropriate snack items, but this was not implemented in practice for this resident.