Resident Not Served Meal During Scheduled Dining Period
Penalty
Summary
During a lunch meal observation, a resident who eats independently did not receive a meal tray while seated in the dining room. The resident's tablemate was served and began eating, but the resident was left without a meal. Staff interviews revealed that the resident's tray was not included in the meal cart due to a kitchen error. The seating arrangement confirmed the resident was assigned to the table according to the facility's dining plan, but the meal was not delivered as expected. Further interviews with staff, including a CNA and the Food Service Director, indicated that meal trays were distributed based on a list provided by the charge nurse. The kitchen staff followed this list to serve meals, but an oversight led to the omission of the resident's tray. The Director of Nursing noted that the resident was present in the dining room during meal service, although this was not their assigned dining location, which contributed to the error. The facility's policy requires that residents be treated with dignity and respect, but this was not upheld in this instance.