Failure to Accommodate Vegetarian Diet Preferences
Penalty
Summary
A deficiency occurred when a resident with a physician-ordered vegetarian, no added salt (NAS) diet was served a meal containing cabbage with bacon. The resident's dietary profile and meal ticket clearly indicated vegetarian preferences, yet the meal tray included an item inconsistent with these requirements. The resident identified the presence of bacon in her cabbage and declined to eat it, stating she does not eat bacon due to her vegetarian diet. Photographic evidence was obtained to document the meal tray contents. Interviews with staff revealed that the dietary and nursing teams were aware of the resident's vegetarian status, and the facility had policies in place requiring nursing staff to verify meal accuracy and dietary staff to accommodate resident preferences. Despite these procedures, the error occurred, and staff could not recall how the incorrect item was served. The resident reported dissatisfaction with the vegetarian options provided, and staff interviews confirmed the process for meal assembly and verification, but did not identify how the mistake was made.