Failure to Follow Prepared Menus Due to Food Supply and Budget Issues
Penalty
Summary
The facility failed to follow menus that were prepared in advance for a period covering 11 meals, resulting in multiple substitutions due to insufficient food supplies. Staff interviews revealed that the facility experienced ongoing shortages of essential food items such as milk, bread, coffee, and sweeteners, with staff members and the dietary manager purchasing food out of their own pockets to supplement the supplies. The dietary manager reported that the allocated budget was insufficient to purchase the food required to follow the planned menus, leading to frequent substitutions and menu changes. The dietician was not always aware of or able to approve all substitutions, and the facility did not provide a dietary policy when requested by the investigator. Observations confirmed that food supplies in the pantry and storage areas were low, with only nonperishable items available for seven days and a lack of posted menus in the dining room. Staff interviews indicated that residents were not always informed about what was being served, and that menu substitutions were made based on what could be purchased within the limited budget. The dietary manager provided a detailed substitution log showing numerous instances where planned meals were replaced with alternative items due to cost or availability constraints. Despite these deficiencies, record reviews indicated that there was no significant weight loss among residents during the period in question, and residents reported that the food was good. However, the facility's failure to follow the prepared menus and ensure adequate food supplies was attributed to budgetary limitations and issues with vendor payments, as confirmed by the DON, Human Resource Director, and dietician. The dietician also expressed concerns about the food budget and acknowledged that she was not always informed of all menu changes.