Failure to Provide Posted Menus, Notify Residents of Substitutions, and Meet Special Dietary Needs
Penalty
Summary
The facility failed to provide daily menus, update menu changes, and notify residents of changes to the menu, as well as failed to provide a nutritionally adequate menu for a resident with a gluten free allergy. Facility policies required that menus be posted in all dining rooms and resident units, that menus be followed, and that substitutions be of equal nutritive value and approved by the dietitian. However, observations and interviews revealed that menus were not posted, and residents were not informed of substitutions or menu changes. Residents reported that alternatives were not always available, and that they were not notified when their chosen food items were unavailable, only learning of substitutions when meals were delivered. One resident with a gluten free allergy was found to have limited food choices due to insufficient gluten free food items available at the facility. The dietary manager confirmed that only gluten free pasta and hamburger buns were purchased, with no bread, cereal, crackers, or other gluten free items available. This resulted in the resident not receiving a nutritionally adequate menu during their stay, as the menu could not be followed in its entirety for this resident. Staff interviews confirmed that the daily menu and alternate menu were not posted for residents and family members to view, and that residents were not notified in a timely manner of food substitutions. The activity assistant collected residents' meal choices each morning but did not inform residents if their choices were unavailable, leading to residents receiving unexpected substitutions at mealtimes. The nursing home administrator acknowledged that menus should be posted and followed, and that residents should be notified of substitutions, confirming the deficiencies identified.