Failure to Follow Approved Menu and Portion Sizes for Specialized Diets
Penalty
Summary
The facility failed to follow the approved dietary menu and portion sizes for multiple residents across various diet types during lunch meal services. Specifically, several residents on puree diets received mashed potatoes instead of whipped sweet potatoes when the facility ran out of the latter, and some residents on regular diets were served portions of roasted turkey that exceeded the prescribed three ounces. Additionally, residents on soft and bite, minced and moist, and puree diets received incorrect scoop sizes for mashed potatoes and meatloaf, resulting in deviations from the planned portion sizes. Two residents on finger food diets were served cut-up red potatoes instead of tater tots and whole meatloaf patties instead of meatloaf bites, contrary to the menu requirements. These deficiencies were identified through direct observation of meal service, staff interviews, and review of facility documents such as diet spread sheets and meal tickets. The dietary staff, including the Day Cook and Kitchen Supervisor, confirmed during interviews that incorrect scoop sizes and substitutions were used, and that menu items were not always prepared as required. The Registered Dietitian also acknowledged that the expectation is to follow the menu and portion sizes as approved. The affected residents were on a variety of specialized diets, including puree, nectar thick, soft and bite, minced and moist, and finger food diets, each with specific nutritional and consistency requirements. The failure to adhere to the approved menu and portion sizes had the potential to result in residents not receiving the Registered Dietitian's approved menu, which could impact their nutritional status and overall clinical condition.