Failure to Follow and Document Approved Menus for Resident Meals
Penalty
Summary
The facility failed to ensure that planned menus were followed and prepared according to the weekly menu for six out of six meals reviewed. Observations, interviews, and record reviews revealed that the posted and served meals did not match the facility's approved weekly menu on multiple occasions. For example, the posted menu and the meals served for lunch and dinner on several days differed from the planned menu, with substitutions made without proper documentation or approval from the registered dietitian. Residents were served alternate items, such as a hamburger without a side, and desserts were substituted due to cost constraints, with no evidence of dietitian approval for these changes. Interviews with staff indicated that the Dietary Director made menu substitutions based on resident preferences and budget limitations, but was unable to provide documentation of dietitian approval for these changes. The Registered Dietitian confirmed that she had not approved the menu changes and that the process required a substitution log to be completed and signed off by the dietitian, which was not done. The Regional Registered Dietitian also stated that while resident feedback is considered, substitutions must maintain nutritional equivalence and be properly documented and approved. The facility's policy requires menus to be prepared in advance, posted in accessible areas, followed as posted, and any deviations to be approved by the dietitian. However, the investigation found that menus were not consistently posted, substitutions were made without proper approval, and documentation of these changes was lacking. This failure placed residents at risk of not receiving meals adequate to meet their nutritional needs.