Failure to Follow Puree Diet Menus for Residents
Penalty
Summary
The facility failed to follow prescribed puree diet menus for two residents during both dinner and lunch meal services. On one occasion, the dinner tray line did not provide the required vegetable portion (tomato juice), bread portion (croissant), puree crackers, or puree fruit plate, nor were appropriate alternate items provided as specified in the puree diet extension. During a subsequent lunch service, the puree menu was not followed as residents received mashed potatoes instead of puree tater tots and were served regular Jello without fruit instead of the required puree fruit cocktail. These omissions were directly observed during meal service. Interviews with dietary staff revealed inconsistencies in understanding and implementing the puree diet menu extensions, with some staff relying on diet sheets and others on the recipe book. The Foodservice Director acknowledged that the correct puree items were missed, and the Registered Dietitian confirmed responsibility for nutritional adequacy but noted that menus were provided by an outside source. The Executive Director stated there was no involvement with cycle menus and that the dietitian follows the recipe book, further indicating a lack of oversight in ensuring menu compliance.