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F0806
D

Failure to Honor Resident Food Preferences and Dietary Needs

Saint Paul, Minnesota Survey Completed on 04-24-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

A resident with end stage renal disease, diabetes, and other chronic conditions was not provided with meals that accommodated his stated preferences and dietary needs. Despite being cognitively intact and able to communicate his preferences, the resident repeatedly received white rice and milk, which he had specifically requested to avoid, and was not given preferred alternatives such as strawberries. The resident also expressed a desire for larger portion sizes, which was communicated to the dietician and dietary manager, but his meal card and actual meals did not reflect these preferences for an extended period. Multiple staff interviews confirmed that the resident had complained for weeks about receiving rice and that his concerns were not addressed by the dietary staff or the registered dietician, who did not recall discussing these issues with him. Observations showed that the resident continued to receive meals inconsistent with his preferences and dietary orders, including being served white rice and cake instead of requested items. The dietary manager and registered dietician were unaware or did not recall the resident's dislikes, and the meal card was not updated in a timely manner to reflect the resident's current diet and preferences. The facility's policy required assessment and communication of food preferences upon admission and care planning if a resident was dissatisfied, but these procedures were not followed, resulting in the resident's preferences not being honored.

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