Failure to Maintain Required Interval Between Dinner and Breakfast Meals
Penalty
Summary
The facility failed to ensure that the lapse between the evening meal and breakfast the following day did not exceed 14 hours, as required. Observations and interviews revealed that meal carts for several areas were delivered for dinner as early as 4:30 PM and breakfast as late as 9:30 AM, resulting in time spans of 15 to 17 hours between meals. Staff interviews confirmed that breakfast was typically served between 8:15 AM and 9:30 AM, and the dinner meal was served as early as 4:30 PM, leading to extended periods without substantial food. Residents and staff reported that the long interval between dinner and breakfast left residents hungry in the morning. One resident specifically stated that the time between dinner and breakfast was too long and that she was very hungry by breakfast. Staff also noted that the facility no longer provided substantial evening snacks, such as sandwiches, and instead only offered small items like crackers or fruit cups if requested. The Director of Dining Services, Certified Dietary Manager, and Registered Dietitian all acknowledged that the current meal schedule did not meet the regulatory requirement of no more than 14 hours between the evening meal and breakfast, and that a nourishing snack should be provided if this interval is exceeded. The Compliance Coordinator indicated that the issue of meal timing had been discussed in Quality Assurance meetings, but no solution had been implemented to ensure compliance. The Registered Dietitian confirmed that the facility was not meeting the requirement to provide a nourishing snack when the interval between dinner and breakfast exceeded 14 hours. The lack of a process to ensure timely meal service and the discontinuation of substantial evening snacks contributed directly to the deficiency.