Failure to Provide Timely SLP Evaluation and Diet Upgrade
Penalty
Summary
The facility failed to ensure that a resident received timely specialized rehabilitative services, specifically a Speech Language Pathologist (SLP) evaluation, after admission. The resident was admitted with a moderate memory impairment and was placed on a mechanically altered diet, despite having no documented chewing or swallowing issues at the time of admission. The resident expressed dissatisfaction with the food texture and reported not understanding the reason for the modified diet. Observations confirmed that the resident was served ground meat, which was left untouched, and the resident voiced complaints to the registered dietician about the food. The SLP evaluation was not completed until eight days after admission, at which point the SLP assessed a mild swallowing impairment and upgraded the resident's diet. Interviews with staff revealed that there was a lack of timely referral and communication between the dietary and rehabilitation departments, which delayed the SLP assessment and subsequent dietary changes. The delay in providing specialized rehabilitative services resulted in the resident remaining on an unnecessarily restrictive diet for several days.