Failure to Provide Diet-Appropriate Food Texture and Preparation
Penalty
Summary
A deficiency occurred when a resident with a physician-ordered Dysphagia Mechanical Soft Texture diet was served a regular meal consisting of uncut spaghetti noodles, regular sliced zucchini, and a regular slice of bread. The nurse aide questioned the appropriateness of the meal, noting the resident typically received pureed food, but the Regional Dietary Manager approved the tray as served. The resident was unable to eat the meal, expressing frustration and stating he could not eat the food due to not having teeth and was supposed to receive tomato soup, which was marked out on the tray ticket. Observations confirmed the food provided did not match the resident's dietary needs or the facility's diet order. Further investigation revealed the zucchini was not prepared according to the facility's recipe or the National Dysphagia Diet (NDD) guidelines. The zucchini was boiled, not baked, and was served in large, tough pieces that were difficult to chew and not consistent with the required texture for a mechanical soft diet. Staff interviews indicated a lack of adherence to recipes and menu guidelines, with some staff unaware of the existence of recipes or proper procedures for preparing food to meet specific diet consistencies. The facility's own diet manual and addendum specified requirements for chopped vegetables and mechanical soft diets, which were not followed in this instance.