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F0584
D

Failure to Honor Resident Food Preferences and Dietary Restrictions

Excelsior, Minnesota Survey Completed on 06-16-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to honor food preferences and dietary restrictions for multiple residents, as evidenced by direct observations, interviews, and review of dietary documentation. One resident with end stage renal disease and a fluid restriction was served items specifically listed as dislikes and not permitted on his diet slip, including milk and apple juice at dinner, as well as potatoes and broccoli. The resident expressed that he was not supposed to receive milk and did not like several items on his tray, which were clearly documented as dislikes. As a result, the resident did not eat his meal. The resident's care plan and dietary slip outlined specific dietary needs and preferences, which were not followed by staff. Additional observations included a resident being served toast despite a documented dislike, with the nursing assistant failing to offer an alternative or notify the kitchen due to time constraints and lack of training. Another resident reported frustration after being served mushrooms, which were also listed as a dislike, and only received a replacement meal after specifically requesting it from the cook. Staff interviews confirmed a lack of awareness and training regarding alternative food options and the process for addressing resident dislikes. The facility's policy required staff to document and honor food preferences, but this was not consistently implemented for the residents involved.

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