Failure to Provide Planned, Nutritionally Adequate Vegetarian Menu
Penalty
Summary
The facility failed to implement a vegetarian menu that was planned in advance and evaluated for nutritional adequacy for two residents who required vegetarian diets. Observations revealed that kitchen staff prepared cheese sandwiches for these residents without following a standardized recipe, and there was no evidence of a planned vegetarian menu or evaluation of its nutritional content. The dietary aide confirmed there was no recipe for cheese sandwiches, and the dietary supervisor indicated that only two slices of cheese, providing 5-6 grams of protein, were used per sandwich, which did not meet the facility's own diet manual guidance for protein content in vegetarian meals. Both residents involved had documented orders for vegetarian diets and the mental capacity to make dietary decisions. One resident reported being a lifelong lacto-ovo vegetarian and stated that her meals often consisted of grilled cheese sandwiches, with the quality and variety of meals varying depending on the kitchen staff. She was unaware of alternative vegetarian options available to her. The other resident, also a long-term vegetarian, reported receiving meals that were high in carbohydrates and lacking in variety and balance, sometimes leading her to supplement her diet with snacks purchased from outside the facility. She also expressed uncertainty about whether certain meals were vegetarian and felt limited in her choices. The registered dietitian confirmed that the facility did not have a vegetarian menu planned a week in advance and could not verify if the meals provided met recommended dietary allowances. Review of facility policies indicated that menus should be planned in advance, provide variety, and meet nutritional needs according to national guidelines, but these requirements were not met for the vegetarian residents. The lack of standardized vegetarian recipes, menu planning, and evaluation for nutritional adequacy led to inconsistent meal quality and potential nutritional deficits for the affected residents.