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F0803
E

Failure to Follow Planned Menus and Provide Scheduled Meals

Nebo, North Carolina Survey Completed on 06-24-2025

Penalty

Fine: $296,905
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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 follow its planned menus for three residents who were reviewed for food preferences. Multiple staff interviews revealed that the kitchen repeatedly ran out of the prepared food items listed on the dinner menu, resulting in residents being served sandwiches instead of the scheduled hot meals. This issue was observed to occur several times, particularly during dinner, and residents reported not receiving the menu items on at least three occasions. Residents were not given choices for substitute meals and expressed a preference for hot meals over cold sandwiches. The dietary manager confirmed that a cook had been replaced due to frequent failures in preparing enough food, despite receiving training and guidance on using recipes and census data to determine appropriate quantities. The dietary manager and relief cook attempted to retrain the cook, but the problem persisted. The cook admitted to being inadequately trained and unaware of tools or formulas to calculate food amounts, leading to repeated shortages and the use of sandwiches as a substitute. Personnel records indicated the cook had been formally written up for not following the menu. Interviews with other staff, including a newly hired cook, revealed that training was primarily on-the-job, with no formal skills check-off or standardized method for determining food quantities. The DON and administrator acknowledged awareness of the issue, noting that residents always received three meals but not necessarily the items listed on the menu. The administrator confirmed that the previous cook did not feel comfortable in the position due to a lack of understanding about meal preparation requirements, and that training and oversight were based on observation rather than formal assessment.

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