Failure to Follow Prescribed Therapeutic Diets and Menu Portions
Penalty
Summary
The facility failed to ensure that prescribed therapeutic diets were followed as indicated on the approved menus for multiple residents. During lunch meal observations, two residents on controlled carbohydrate (CCHO) diets received a full slice of garlic bread instead of the prescribed half slice, as confirmed by both menu documentation and the registered dietitian. Additionally, 22 residents on fortified diets did not receive the required extra melted margarine and salad dressing, which were specified on the fortified menu to provide additional calories for those at risk of weight loss. The registered dietitian confirmed that these fortified foods were not provided as required. Further deficiencies were observed when two residents with puree diet orders were served mashed potatoes instead of the prescribed pureed red beans and rice, as indicated on the menu for that meal. Additionally, two residents with orders for half portion sizes were instead served small portion sizes, with the dietary supervisor incorrectly equating the two. The registered dietitian clarified that half portions should be exactly half of the regular portion, and noted that only verbal in-services had been conducted regarding portion sizes, with no formal training or policy in place. The facility's policy required adherence to prepared menus and portion control guides, but these were not followed during the observed meals.