Failure to Provide Nutritious, Palatable Meals and Document Substitutions
Penalty
Summary
Surveyors identified multiple deficiencies related to the facility's failure to provide meals that meet residents' nutritional needs and preferences, as required by national guidelines and facility policy. Observations revealed that the kitchen stored unlabeled and uncovered produce, including rotting lettuce, and used old menus that were not current. During meal service, food was found to be served at suboptimal temperatures and described as flavorless and unappetizing by both surveyors and residents. Additionally, a cook was observed pureeing food with water instead of more nutritious liquids, and not following a specific recipe. Interviews with residents consistently indicated dissatisfaction with the meals, citing issues such as lack of flavor, repetitive menu items, poor food quality, and unappetizing alternatives. Several residents reported regularly refusing meals or choosing alternatives like cereal due to the poor quality of the main offerings. Staff interviews confirmed awareness of these complaints, and the Dietary Manager (DM) acknowledged that substitutions were offered but not documented, as required by facility policy. The DM also admitted to not inspecting food quality at delivery and not labeling returned items, and was unaware of some staff meal preparation practices that could affect food quality. Record reviews showed that facility dietary policies require proper labeling, dating, and storage of food, prompt and efficient meal service to maintain appropriate temperatures, and documentation of resident acceptance or refusal of meal substitutions. However, these policies were not consistently followed, as evidenced by the lack of documentation for meal refusals and substitutions, improper food storage, and failure to ensure meals were appetizing and at the correct temperature. No information was provided regarding corrective actions or follow-up after these deficiencies were identified.