Failure to Provide Appropriate Menu Substitutions for Special Diet
Penalty
Summary
A deficiency was identified when a resident with special dietary needs did not receive appropriate menu substitutions in accordance with her prescribed diet. The resident, who had recently discontinued tube feedings and was transitioning back to oral intake, was observed at lunch receiving spaghetti with small pieces of meat and green peas, along with a pudding-type dessert. The menu for that meal listed spaghetti, garlic bread, and a green salad, but the resident did not receive suitable substitutes for the garlic bread or salad, despite her dietary restrictions. The resident expressed disappointment with her meal, noting the lack of appropriate alternatives. Review of the resident's medical record showed she required a soft-bite and pre-cut food diet, as approved by the Registered Dietitian (RD), and had specific restrictions to avoid certain foods due to severe inflammation and gastric irritants. The daily menu spreadsheet indicated that substitutions should have been provided, such as soft steamed vegetables or mashed vegetables for salad, and pureed bread for garlic bread. The Dietary Manager confirmed that changes to diet orders were communicated by the RD and entered into the dietary system, but acknowledged that appropriate substitutions were not made for this resident's meal.