Failure to Use Nutritive Liquids in Pureed Food Preparation
Penalty
Summary
The facility failed to ensure that pureed foods were prepared using methods that conserve nutritive value, flavor, and appearance for residents on a pureed diet. During a lunch observation, a cook pureed chicken tenders and broccoli using only water, rather than broth or cooking juices, to achieve the required consistency. The cook did not follow a specific recipe and added water incrementally until the food resembled pudding. The dietary manager confirmed that staff were trained to use small amounts of water but preferred broth for pureeing meats, acknowledging that water could dilute both taste and nutritional value. The registered dietitian also stated that recipes typically call for broth or cooking liquids, not water, to maintain nutritional content. Further interviews revealed that the cook was aware of the expectation to use meat or vegetable juices but resorted to water due to time constraints and lack of available juices. The dietary manager and administrator both indicated that recipes were accessible through the facility's computer system, but not all staff had them, and there was no specific policy regarding therapeutic diets. Review of in-service training materials indicated that broth, milk, or juice should be used to adjust the thickness of pureed foods, not water. This practice was not followed during the observed meal preparation.