Failure to Provide Nutritive Vegetarian Meal Alternative
Penalty
Summary
The facility failed to provide a vegetarian alternate meal of similar nutritive value for a resident who required a vegetarian diet. During meal service, the resident received a cheese sandwich containing two slices of processed cheese, which provided only 5 grams of protein, compared to the main entrée of Hawaiian chicken that provided approximately 21 grams of protein. The dietary aide preparing the sandwich stated there was no recipe to follow, and the facility did not have standardized vegetarian recipes or planned vegetarian alternatives to ensure nutritional adequacy. The resident’s meal tray card indicated a vegetarian diet with no meats and a preference for veggie patties and cheese, but the meal provided did not meet the facility’s own diet manual guidance, which required 2 to 3 ounces of protein equivalent at lunch. Further review with the registered dietitian and dietary services supervisor confirmed that the cheese sandwich did not meet the protein requirements outlined in the facility’s diet manual. The facility also lacked vegetarian menus and standardized recipes that were analyzed for nutritional adequacy, and staff were unaware of vegetarian alternatives noted in the recipe for the main entrée. The facility’s policies required the use of approved, standardized recipes and the provision of suitable nourishing alternate meals, but these procedures were not followed in this instance.