Failure to Provide Menus and Meals Meeting Residents' Therapeutic Dietary Needs
Penalty
Summary
The facility failed to ensure that meals were provided in accordance with established nutritional standards and did not meet the specific dietary needs of residents. Observations and interviews revealed that menus were not consistently followed, and staff often prepared meals based on available food rather than the planned menu. The menus provided to kitchen staff did not include detailed therapeutic breakdowns for specialized diets such as No Added Salt (NAS), Low Concentrated Sugar (LCS), Low Fat, Low Potassium, and Low Lactose diets, despite a significant number of residents requiring these modifications. Staff interviews indicated a lack of clarity and resources regarding which menu week was being used, and the absence of therapeutic diet information on the menus. The Food Service Director and kitchen staff reported that they relied on resident tray tickets for diet orders but did not have guidance on specific food restrictions or portion sizes for specialized diets. Additionally, there were instances where meals served did not align with the planned menu due to food shortages or equipment issues, further compromising the ability to meet residents' dietary needs. The Registered Dietician confirmed that the menus lacked the necessary therapeutic breakdowns and emphasized the importance of providing and following diet orders for residents with conditions such as hypertension, congestive heart failure, and diabetes. The Food Service Director acknowledged that therapeutic diets were not in place when he started and that the current system did not support the provision of appropriate meals for residents with specialized dietary requirements.