Failure to Provide Requested Second Helping of Food
Penalty
Summary
A deficiency occurred when a resident, identified as having heart disease, hypertension, hyperlipidemia, and being moderately cognitively intact, was not provided a requested second helping of food during a meal. The resident's care plan indicated a potential for altered nutrition and included interventions such as monitoring food and fluid intake and offering snacks. During meal service, the resident requested more watermelon, but a nursing assistant informed her that there was no more available without checking with the kitchen. The dietary aide later confirmed that there was additional watermelon available and that residents could have seconds if permitted by their diet. Staff interviews revealed inconsistent understanding of the policy regarding second servings, with the nursing assistant stating residents only receive one serving, while the LPN and RN indicated that seconds are allowed unless restricted by diet. The facility's policy emphasized treating residents with dignity and offering choices at mealtime, including what to eat. The failure to provide the requested second helping was attributed by one staff member to being rushed due to staffing issues, and the dietary manager was responsible for monitoring meal service for preferences and portion sizes.