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F0809
F

Failure to Provide Timely Meals and Snacks According to Resident Needs and Preferences

Richmond, Virginia Survey Completed on 04-28-2025

Penalty

Fine: $93,440
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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

Facility staff failed to provide meals and snacks at regular times and in accordance with resident needs, preferences, and requests across all three units. During a resident council meeting, ten alert and oriented residents from all units reported that bedtime snacks were rarely offered, and snacks were not provided on a regular basis. Residents with diabetes stated they did not consistently receive snacks, and snacks left at the nursing station were only accessible to ambulatory residents, leaving non-ambulatory residents without. Residents also observed nursing staff consuming snacks intended for residents. Additionally, complaints were made about the quality and variety of food, with residents noting that meals were often salty and starchy, and fresh fruit options were limited to bananas, with canned fruit tasting old. Observations confirmed that snacks were not offered or provided to residents prior to surveyor intervention. Meal delivery was delayed, with one resident observed waiting for breakfast and unable to obtain coffee before trays arrived. Breakfast trays were delivered late to certain units, and there were inconsistencies in meal delivery times, resulting in some residents having only two to two and a half hours between breakfast and lunch, and more than 14 hours between dinner and breakfast. Facility documentation corroborated these extended intervals between meals. Residents attributed these issues to chronic short staffing, which they stated affected the timeliness of meal service and led some to order food from outside due to hunger and dissatisfaction with the facility's food. Interviews with the Dietary Manager revealed that only residents with diabetes were provided with bedtime snacks, as per the dietary contract, and that snacks for other residents were not supplied. The Dietary Manager acknowledged complaints about meal delivery times and stated that efforts were made to deliver meals as quickly as possible, with dietary staff delivering carts and nursing staff distributing trays. Despite these efforts, the survey team found that most residents did not receive a bedtime snack, and meal delivery was not consistently timely, resulting in long intervals between meals and unmet resident preferences.

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