Failure to Accommodate Resident Food Preferences During Meal Service
Penalty
Summary
The facility failed to accommodate the documented food preferences of three residents during a lunch meal service. One resident, with a history of anemia and vitamin D deficiency, did not receive the double portion of protein as specified on her meal ticket and confirmed this during an interview. The Dietary Manager also verified that the lunch tray did not include the required double protein portion. Another resident, also diagnosed with anemia, had a preference for a green vegetable with every meal, specifically requesting a green salad, but did not receive any salad with her lunch. This was confirmed by both the resident and the Dietary Manager upon review of the meal tray. A third resident, with a diagnosis of vitamin D deficiency, had a preference for fresh fruit for dessert, as indicated on her meal ticket. During observation and interview, it was noted that no fresh fruit was provided on her lunch tray, and the resident expressed concern about its absence. The Registered Dietician confirmed that the fresh fruit was not included and acknowledged that residents' food preferences should have been honored according to their choices. The facility's policy requires staff to determine and provide for residents' food preferences at meals, but this was not followed for these three residents.
Plan Of Correction
This plan of correction constitutes the facility's written credible allegation of compliance. Preparation and/or execution of this Plan of Correction does not constitute admission or agreement by the provider of the truth of the facts alleged or the conclusion set forth on the Statement of Deficiencies. This plan of correction is prepared and/or executed solely because required by the provisions of the health and safety code section 1280 and 42 CFR 483. Immediate corrective action(s) for those Residents affected by the deficient practice: Dietary Manager (DM) and Resident 1 communicated to clarify this resident's preference as it was stated small portions and double protein. Residents requested to maintain small portions and remove double protein. Dietary Manager updated resident's preferences. Registered Dietitian (RD) clarified with Resident 2 that she wants green vegetables with lunch and a spinach salad during dinner, no green vegetable with breakfast. Resident's meal ticket updated with these preferences. In addition to a preference on her meal ticket, RD added Resident's request to the standing daily meal request list to ensure our staff prepare and serve this each meal. RD clarified with Resident 3 who confirmed she wants fresh fruit with all meals, and this Resident's meal ticket updated reflecting this. Plan / Process to identify other residents potentially affected by the same deficient practice and corrective action(s) to be taken; All residents have the potential to be negatively affected if Resident's preferences aren't followed. Facility measures and systemic changes to ensure the deficient practice does not recur; Systemic changes to address the deficient practice include, but are not limited to auditing all current residents' preferences regarding double protein, green vegetables with every meal, and fresh fruit for dessert. RD to clarify that double protein requests are nutritionally appropriate. Dietary Manager will create a list of residents who request green vegetables with every meal and fresh fruit for dessert and assign a Dietary Aide to prepare an adequate number of items prior to meal service. Each of the following team members will audit 2 meal services per week by pulling 4 random trays prior to each meal cart exiting the kitchen. The attached audit form will be utilized for this audit.