Failure to Provide Menu Extensions and Standardized Recipes for Mechanical Soft Diets
Penalty
Summary
The facility failed to ensure that menus were developed and implemented for residents requiring a mechanical soft diet, as required by policy and regulation. Specifically, there were no menu extensions or standardized recipes for the mechanical soft diet, and staff relied on modifying regular menu items based on personal experience rather than following established guidelines. The Registered Dietitian (RD) confirmed that upon her hiring, she identified the absence of menu extensions for therapeutic and texture-modified diets, and that the facility was using menus from the Assisted Living Facility, which did not include necessary modifications. The Dietary Manager and Kitchen Manager both acknowledged that they did not have recipes or menu extensions for mechanical soft diets and instead made substitutions or modifications as they saw fit, such as replacing soft tortillas with rolls for residents on mechanical soft diets. During meal observations, residents on mechanical soft diets were served food items that were not consistent with the planned menu or their preferences, and there was no documentation or recipe to guide appropriate substitutions. For example, a resident expressed dissatisfaction when served a roll instead of a taco, and staff explained that mechanical soft diets could not include tortillas due to choking risks. The RD and dietary staff confirmed that there were no standardized recipes or menu extensions in use, and that the current practice was to adjust meals based on staff judgment rather than established dietary guidelines.