Failure to Provide Physician-Ordered Therapeutic Diet
Penalty
Summary
A deficiency occurred when a resident with diagnoses of protein-calorie malnutrition and hyperlipidemia, who was moderately cognitively impaired and dependent on staff for several activities of daily living, was not provided with the therapeutic diet as ordered by the physician. The resident's Minimum Data Set and speech therapy evaluation indicated a need for a carbohydrate-controlled, mechanical soft diet with regular/thin liquid consistency, and the physician's order specified a dysphagia mechanical soft texture. However, multiple observations revealed that the resident was consistently served a pureed diet instead of the ordered mechanical soft diet. Interviews with the resident, a CNA, and the Director of Dietary Services confirmed that the resident had been complaining about the food texture for at least a week, and possibly as long as six months. The Director of Dietary Services acknowledged that the resident's tray did not match the physician's order, and the DON confirmed that the diet should have followed the speech therapy evaluation and physician's order. The facility's policy required meals to be consistent with physician orders and resident preferences, but this was not followed in the resident's case.