Failure to Follow Puree Diet Menu and Obtain Dietician Approval for Substitutions
Penalty
Summary
The facility failed to follow the planned menu for residents prescribed a puree diet, as observed during meal service and confirmed through staff interviews and document review. Specifically, five residents on a puree diet were served enchiladas, corn, black beans, and pie, instead of the scheduled menu items which included Mexican street cornbread and a snickerdoodle cookie. The Dietary Director confirmed that the cornbread was not prepared for puree diets and that pie was substituted for the cookie. Review of the substitution log revealed that multiple menu substitutions had occurred over a two-month period without the required sign-off from the registered dietician. The registered dietician confirmed she had not reviewed or signed off on these substitutions. Facility policies required that menu changes be evaluated by the dietician and that residents' nutritional needs be met through well-balanced diets.