Failure to Provide Equivalent Meal Substitutes and Honor Food Preferences
Penalty
Summary
The facility failed to provide meal substitutes that were equivalent in nutritive value and did not honor food preferences for certain residents. Specifically, two residents on specialized diets (carbohydrate controlled and low potassium) received grilled cheese sandwiches as meal substitutes for lunch. The facility's menu indicated that the standard entree, pork roast, provided 23 grams of protein and 173 kilocalories, while the grilled cheese sandwiches, as prepared, only provided 5 grams of protein and 90 kilocalories. The recipe called for three ounces of cheese per sandwich, but staff used only two slices (one ounce) of cheese, resulting in a significant shortfall in both protein and caloric content. The Registered Dietitian confirmed that the meal substitute should be equivalent in nutritive value and that the sandwiches were not prepared according to the recipe. Additionally, the facility did not honor the food preferences of another resident who had documented dislikes for certain vegetables, including squash, carrots, and green beans. Despite this, the resident was served a vegetable mixture containing these items and reported that this occurred frequently. The Menu Planner stated that the Registered Dietitian had instructed her to serve a hot vegetable to all residents, but the Dietitian later clarified that a salad could be substituted if a resident disliked the hot vegetables and that it was not necessary to serve both a salad and hot vegetables.