Failure to Provide Chopped Vegetables as Ordered for Resident with Dysphagia
Penalty
Summary
The facility failed to provide food prepared in a form designed to meet the individual dietary needs of a resident with a physician-ordered mechanical soft, chopped diet. The resident, who had mild oropharyngeal dysphagia and reduced dentition, was observed during lunch receiving long pieces of napa cabbage, exceeding one inch in size, instead of the required chopped vegetables of approximately half an inch. The meal ticket and physician orders specified chopped meats and vegetables, and the facility's policy for dysphagia mechanical diets also required cooked vegetables to be chopped to about half an inch and soft to a mashable texture. Multiple staff, including an LVN, the Dietary Services Supervisor (DSS), and the Speech Therapist, confirmed that the vegetables served did not meet the prescribed dietary modification. The DSS and Speech Therapist both verified that the vegetables should have been chopped to thumbnail size, and the LVN acknowledged the discrepancy between the meal ticket and the food served. The resident's medical record and therapy notes supported the need for a mechanical soft, chopped diet to facilitate ease of swallowing.