Failure to Prepare and Follow Advance Menus with Diet-Specific Modifications
Penalty
Summary
The facility failed to ensure that menus were prepared in advance and included necessary details such as serving sizes and diet-specific modifications for residents' diet orders. During the survey, the facility was unable to provide complete menu cycles and menu extensions for all diets, and the available documentation did not specify which foods were appropriate for various modified diets, including soft, bite-sized, potassium-restricted, finger food, reduced sodium, no added salt (NAS), and renal diets. Observations revealed that meals served did not always match the planned emergency menus, and handwritten instructions for meal preparation lacked information on portion sizes and diet accommodations. Staff interviews confirmed that, following a kitchen fire, the facility relied on emergency menus but did not consistently provide documentation or guidance for dietary modifications or portion sizes. Residents reported receiving meals that differed from the emergency menu, and dietary staff were observed preparing meals without clear instructions on the amount of food to serve or how to modify meals for specific diets. The Registered Dietician stated that the food service vendor provided menus and recipes for all diets, but these were not fully utilized by the dietary manager during the emergency period. The facility was unable to provide a dietary policy regarding menu preparation and documentation before the survey exit, and the lack of clear, advance menu planning and documentation placed all residents receiving oral meals at risk of nutritional problems and dissatisfaction.