Failure to Honor Resident Meal Preferences for Fried Eggs
Penalty
Summary
The facility failed to honor a resident's meal preference for fried eggs with runny yolks, despite the availability of pasteurized eggs, which are permitted under federal regulations for such preparations. The resident, who had intact cognition and no delusional thinking, repeatedly requested fried eggs but was consistently denied this choice by management. Observations confirmed that the resident was served hard-boiled eggs instead, while other residents were seen consuming eggs with runny yolks in the dining room. The dietary manager's progress note documented informing the resident that only fully cooked eggs would be served, but did not provide a rationale for this restriction, even though pasteurized eggs were available in the facility. Interviews with staff, including a cook and the assistant director of nursing, revealed confusion and lack of consensus regarding the policy for serving fried eggs. The cook confirmed that pasteurized eggs were available and believed it was acceptable to serve fried eggs using them, but stated that the facility owner did not allow it, without providing a clear reason. The assistant director of nursing acknowledged that the interdisciplinary team had discussed the issue but had not reached a decision, and recognized the importance of resident choice in meal options. The resident's nutritional care plan did not address the restriction on fried eggs, nor did it provide any clinical justification for denying the resident's preference. The facility was unable to produce a policy on meal choices when requested. The lack of documentation, clear rationale, and consistent practice regarding resident meal preferences led to the deficiency in accommodating resident choice and promoting quality of life.