Failure to Ensure Resident Receives Palatable, Well-Balanced Diet Respecting Preferences
Penalty
Summary
The facility failed to ensure the nutritional well-being of a resident while also respecting the individual's right to make choices about their diet. The resident, who had diagnoses including chronic respiratory failure, tracheostomy status, COPD, and hypertensive heart disease, was placed on a heart-healthy, consistent carbohydrate diet with specific restrictions. Despite having an intact cognitive status, the resident reported dissatisfaction with the repetitive nature of the meals, specifically mentioning frequent servings of chicken and occasional meals without meat. The resident also expressed a lack of understanding about the heart-healthy diet and reported not being able to read the posted menu in their room. Interviews with staff revealed that dietary preferences were supposed to be accommodated through a preference slip and that an alternate menu was posted in the resident's room. However, both the surveyor and the resident confirmed that the menu was not legible to the resident. The Dietary Assistant Supervisor acknowledged the issue and stated that while efforts were made to accommodate preferences and provide alternatives, changes to the diet required permission, and there was uncertainty about portion sizes for certain meals. The staff also indicated that the resident could request changes through CNAs or nurses, but the resident had not requested more food. Further, the administrator noted challenges with the resident and their representative bringing in outside food and not adhering to the prescribed diet, despite education efforts. The Registered Dietitian monitored the resident's intake and menu compliance, but the resident continued to express dissatisfaction with the food provided and the lack of variety. These actions and inactions led to a failure to provide a nourishing, palatable, well-balanced diet that met the resident's nutritional and personal preferences, as required by regulation.