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F0656
E

Failure to Address Resident's Plant-Based Diet Preference in Care Plan

Petersburg, Virginia Survey Completed on 07-25-2025

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

Facility staff failed to develop a care plan that addressed a resident's preference for a plant-based diet, despite being aware of this preference. The resident, who was admitted under hospice care with diagnoses including malignant ovarian and endometrial cancer, morbid obesity, and atrial fibrillation, was cognitively intact and dependent on staff for most self-care activities. The resident reported experiencing frequent nausea and vomiting over several days due to not receiving her preferred plant-based meals, which she stated had been agreed upon with the facility. She attempted to supplement her diet by purchasing bean burritos from a local restaurant, but staff disposed of them due to storage policies, and she was initially told she could not have a personal refrigerator in her room. The resident's nutritional care plan identified her risk for malnutrition and included interventions such as identifying food preferences and offering substitutions, but did not specifically address her plant-based diet preference. Staff interviews confirmed awareness of the resident's dietary preference, but the care plan was not updated to reflect this, and facility policies regarding personal refrigerators were not initially clarified. The deficiency was acknowledged by facility leadership during the survey process.

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