Failure to Accommodate Resident Food Preferences and Heating Requests
Penalty
Summary
A deficiency occurred when the facility failed to provide reasonable accommodations for a resident who refused to eat facility-prepared food and relied on meals brought in by family. The resident, who was cognitively intact and had diagnoses including lupus erythematosus, arthritis, protein-calorie malnutrition, and major depressive disorder, stored her food in her room refrigerator and requested that staff heat her meals. The facility was aware of her preferences, as documented in her care plan, but did not consistently meet her requests to have food heated, particularly after the unit microwave broke and staff were instructed to use the kitchen instead. On a specific occasion, the resident requested that a CNA ask a dietary aide to heat up a can of chili. The dietary aide refused, stating she was done cooking and would not do it, despite the resident referencing prior approval from the dietary manager. The dietary aide later acknowledged the refusal, explaining it was during kitchen clean-up and she was already heating food for another resident. The resident reported feeling uncomfortable and hesitant to request warm meals after this incident, and staff interviews confirmed the refusal and the lack of a consistent process for accommodating such requests. The facility's policy on resident rights emphasizes self-determination and the right to make choices about significant aspects of life in the facility. However, the resident's need for her food to be heated was not accommodated in a timely or consistent manner, and limitations were placed on when her food could be heated. The incident was not promptly communicated to the nursing home administrator, who later acknowledged the failure to meet the resident's needs and the unreasonableness of restricting food heating to certain hours.