Failure to Offer Meal Choices to Resident on Pureed Diet
Penalty
Summary
The facility failed to honor a resident's right to make choices about food at meals for a resident with severe cognitive impairment and dysphagia requiring a pureed, nectar-thick diet. Despite the resident's ability to verbalize preferences, staff did not offer meal options, instead providing the same predetermined pureed meal to all residents on similar diets. Interviews with staff, dietary personnel, and family confirmed that the resident was not asked for meal preferences, and the kitchen routinely pureed only the first menu option for these diets. The care plan indicated the resident could feed herself with assistance and had specific beverage preferences, but these were not consistently honored. Observations and interviews revealed that while residents on regular diets were offered meal choices, those on mechanically altered or pureed diets were not, regardless of their ability to express preferences. Staff and dietary management acknowledged this practice, citing concerns about food waste and assumptions about residents' decision-making abilities. The facility's policy on diets did not address the provision of meal choices for residents on modified diets, contributing to the lack of individualized meal options for the affected resident.