Failure to Document and Resolve Resident Grievance Regarding Meal Portions
Penalty
Summary
A deficiency occurred when the facility failed to address and resolve a resident's grievance regarding meal portion sizes. The resident, who was cognitively intact and had multiple medical diagnoses including a left femur fracture, COPD, diabetes, and heart failure, reported concerns about not consistently receiving double portions with meals as requested. The resident communicated these concerns to their assigned caring partner, a CNA Scheduler, but there was no documentation of the grievance in the facility's grievance log, and the resident's care plan and meal tickets did not reflect the request for double portions. The facility's policy requires that all grievances be documented and forwarded to the grievance official, but this process was not followed in this case. Interviews with staff revealed that the CNA Scheduler, who was new to both the facility and long-term care, did not complete a grievance form or report the concern to social services, believing the issue was addressed verbally with the Dietary Manager. The Dietary Manager confirmed the concern was handled verbally and acknowledged that the meal tickets did not reflect the resident's preferences, which was an oversight. The Social Services Director was unaware of the concern and reiterated that all grievances should be documented. The lack of documentation and formal follow-up resulted in the resident's grievance not being properly addressed according to facility policy.