Failure to Follow Prescribed Menus and Portion Sizes During Meal Service
Penalty
Summary
The facility failed to ensure that lunch menus and meals met the nutritional needs and preferences of residents, as evidenced by multiple discrepancies during meal preparation and service. Observations revealed that a cook pureed two pork steaks for lunch service without measuring the final volume of the puree, despite a chart indicating the required portion size. Three residents received approximately three-fourths of a #8 scooper serving size of pureed pork, even though only two residents were on a pureed diet and one was on a liquefied diet. The liquefied diet was prepared by mixing pureed meat with hot water in a mug, and the Certified Dietary Manager (CDM) was unsure of the standard procedure for preparing liquefied food. Sample menus indicated that the correct number of servings should be processed to meet dietary requirements, but this was not followed. Additionally, there were several instances where residents did not receive the supplements or side dishes indicated on their lunch tickets. One resident did not receive a Magic Cup supplement, another received a Mighty Shake instead of a Magic Cup, three residents did not receive a Mighty Shake supplement, one resident did not receive a side dish of cottage cheese, and one resident did not receive ice cream. These omissions and substitutions were confirmed by staff interviews and direct observation, indicating a failure to follow prescribed menus and meal tickets, and to meet the documented nutritional needs and preferences of the residents.