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F0806
F

Failure to Provide Food According to Resident Preferences and Diet Orders Due to Dietary Communication Barriers

Rochester, Pennsylvania Survey Completed on 08-12-2025

Penalty

No penalty information released
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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 provide food products that accommodated resident preferences and prescribed diets for residents on two nursing units, The Gardens and Scenic Heights. During a lunch observation, a nurse aide identified that a resident who was ordered a regular diet received minced and pureed food instead. This issue was reported to the unit clerk, who attempted to contact the Dietary Department but was unable to reach anyone or leave a message, as the phone system did not allow for messages and was frequently unanswered. Staff interviews confirmed that this communication barrier with the Dietary Department was a recurring problem, often resulting in significant delays in correcting meal errors. Residents reported consistently receiving incorrect or undesired food items, with one resident stating that she was regularly given food she would not eat, and another noting that requested items, such as a salad, were repeatedly not provided. Staff, including an LPN, corroborated the difficulty in reaching the Dietary Department to address these issues. The registered dietitian confirmed that the facility failed to provide the correct diet to the affected resident and was unable to honor food preferences for both nursing units due to the inability to take or respond to phone calls for food requests.

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