Failure to Provide Timely Meal Delivery and Coordinate with Medication Administration
Penalty
Summary
The facility failed to ensure that meals and snacks were served in accordance with residents’ needs, preferences, and requests, particularly regarding timely delivery and coordination with medication administration. Observations, interviews, and record reviews revealed that meal trays were consistently delivered late across all three units observed. Residents reported significant delays, with one diabetic resident noting that the timing of meal delivery was inconsistent and impacted the administration of insulin. Another resident and several others agreed that meals were not delivered on time, and a family member reported that late meal delivery affected the timing and effectiveness of medications, especially those intended to assist with sleep. Requests for alternate food items also experienced delays, sometimes taking up to 30 minutes, and on weekends, kitchen staff were often unavailable to respond to requests, leading family members to bring food from home. Review of the facility’s Food Truck Delivery Daily Tracking Logs showed that on 25 out of 29 days, meals were delivered 20 minutes or more after the scheduled time. Surveyors directly observed multiple instances of late meal delivery, with food trucks arriving significantly past their scheduled times. The Food Service Director acknowledged being aware of occasional late meals but was not aware of the consistency or extent of the issue, as she did not routinely review delivery logs unless a concern was raised. The Administrator also confirmed awareness of the ongoing problem with meal delivery times.