Failure to Accommodate Resident Food Allergies and Preferences
Penalty
Summary
The facility failed to ensure that a resident's menu and individual food plan met their documented nutritional needs and preferences. The resident, who had diagnoses including malnutrition and dysphagia and received extra calories via a PEG tube, was noted to have allergies and dislikes including gluten, eggs, mushrooms, mayonnaise, and tomato products. Despite this, observations showed that the resident was served a hamburger with mayonnaise and battered onion rings, which contained gluten, as well as gluten-free pasta with tomato sauce, which the resident disliked and refused to eat. The resident expressed dissatisfaction and concern about the presence of gluten and other disliked items in their meals. Interviews with staff revealed that meal tray cards listing allergies and dislikes were used to guide food preparation, but limitations in available gluten-free options from the food vendor resulted in the resident receiving inappropriate food items. The Food Services Director acknowledged that alternatives were not available for certain menu items, leading to the resident being served foods containing allergens or items they disliked. The facility's policy required accommodation of allergies and preferences, but this was not consistently implemented for the resident in question.