Failure to Follow Planned Menu and Portion Sizes for Pureed Diets
Penalty
Summary
Facility staff failed to follow the planned menu for residents requiring pureed diets during meal preparation and service. Observations showed that staff did not use the correct number of servings or portion sizes as indicated on the menu and by facility policy. Specifically, during the preparation of pureed lemon chicken, only one piece of garlic bread was used to thicken four servings of chicken, instead of the required four pieces. Staff also did not prepare enough pureed chicken to provide the full portions for each resident, and the correct scoop sizes were not consistently used during service. Staff interviews confirmed that these deviations occurred due to time constraints and oversight. During meal service, residents on pureed diets did not consistently receive all menu items. For example, one resident did not receive the full portion of pureed meat, and nine trays were served without garlic bread. Staff acknowledged that the omission of garlic bread and insufficient portions of pureed meat were due to forgetting and running out of prepared food. The dietary aide relied on the extended menu but did not ensure all items were served as planned, and the cook did not prepare enough pureed food to meet the menu requirements. The Certified Dietary Manager and Administrator both confirmed that the facility's expectation was for staff to follow the menu completely, including serving the correct portions and all menu items to residents on pureed diets. Facility policy required therapeutic diets to be individualized and to coincide with the menu extensions, but these standards were not met during the observed meal service. The deficiency was identified through review of menus, observations, staff interviews, and policy review.