Failure to Provide Prescribed Renal Diet and Fluid Restriction
Penalty
Summary
The facility failed to provide a prescribed therapeutic renal diet to a resident with complex medical needs, including end stage renal disease, severe protein-calorie malnutrition, and a fluid restriction. Despite clear dietary orders and documented food preferences, the resident was repeatedly served meals that did not comply with his renal diet or fluid restrictions. On multiple occasions, the resident received items such as milk and apple juice, which were not permitted, and was not provided with double portions as required. The resident also reported receiving foods he disliked and was not supposed to have, such as potatoes and broccoli, and was not offered adequate calorie intake, especially after being away from the facility for medical appointments. Interviews with dietary staff and the registered dietician revealed a lack of awareness and adherence to the resident's prescribed diet. The dietary manager acknowledged that the correct diet was not served on at least two occasions and noted confusion among staff regarding the provision of second helpings. The registered dietician was unaware of the ongoing issues and relied on dietary staff to follow the prescribed orders. The facility was unable to provide a policy related to prescribed diets during the survey, and the resident's care plan clearly outlined the need for increased protein, fluid restriction, and communication with the renal dietician, which was not consistently implemented.