Menu Not Followed and Lacked Dietician Approval
Penalty
Summary
The facility failed to follow the prescribed menu and obtain required Registered Dietician (RD) approval for menu changes and the current menu cycle. For one resident on a mechanical soft diet, the cook provided a lunch that substituted green beans for carrots and omitted baked beans, based on the Dietary Manager's (DM) decision. The DM stated that the RD approved omitting the baked beans without replacement, as the remaining items were considered nutritionally adequate. However, the RD later clarified that while she approved omitting the baked beans, she was not consulted about replacing carrots with green beans and would have required an additional carbohydrate, such as a potato, to meet nutritional needs. Additionally, the facility's current spring/summer menu lacked the RD's signature of approval. The RD reported she had not received the new menu for review and approval, and the last menu she signed was for the previous fall/winter cycle. The DM and Administrator believed the menus had been approved, but the RD confirmed she had not yet reviewed or signed the current menu. Facility policy requires menus to be prepared in advance, followed as written, and reviewed by the RD for nutritional adequacy, which was not done in this instance.