Failure to Honor Resident Food Preferences and Communicate Meal Substitutions
Penalty
Summary
A deficiency occurred when a resident did not receive their requested breakfast items as listed on their meal ticket. During incontinence rounds, the resident, who was alert and cognitively intact with a BIMS score of 15, reported receiving only cereal and a biscuit, and stated that pancakes, which were supposed to be included, were missing. The resident indicated this was not the first time they had not received all ordered food items. The Assistant Director of Nursing (ADON) confirmed that after checking with the kitchen, pancakes were not available and a sandwich was provided as a substitute, but this substitution was not communicated to the resident prior to meal delivery. The resident's medical record showed they were on a regular texture and thin liquid diet, with diagnoses including hypertension and generalized muscle weakness. The facility's policy required that alternate meal selections be provided in a timely manner and that individual food preferences be honored. However, the resident was not informed in advance about the unavailability of pancakes or offered substitution options before receiving their tray, resulting in the facility failing to honor the resident's dietary preferences as required.