Failure to Provide Menu Choice Items and Substitutions
Penalty
Summary
A deficiency was identified when a resident with diagnoses including hyperlipidemia, dysphagia, and gastro-esophageal reflux disease was not provided with all menu choice items as listed on their meal ticket. The resident, who was cognitively intact and on a mechanically altered, therapeutic diet, received only a hot dog, apple juice, and water during a meal, while other listed items such as baked beans, chips, and pickles were unavailable. No substitutions were offered, and the resident reported that the kitchen was frequently out of stock of multiple items. Staff serving the meal confirmed the unavailability of the menu items and were unsure of the reason, noting they did not handle ordering. Further investigation revealed that the Food Service Director was unaware that the items had not been ordered or delivered, and there was no documentation indicating the items were out of stock. The Dietician acknowledged hearing resident concerns about not receiving chosen menu items and stated that appropriate substitutions should be offered when items are unavailable. Additionally, there were no notes from the monthly food committee meetings, and the facility was unable to provide a policy regarding food ordering and menu choices.