Failure to Provide Palatable Food During Meals
Penalty
Summary
Surveyors found that the facility failed to provide palatable food to residents, as evidenced by multiple instances where residents were served burnt bread during meals. Specifically, three residents with varying medical conditions, including hemiplegia, dysphagia, dementia, diabetes, Alzheimer's disease, and muscular dystrophy, were observed during lunch receiving Italian rolls that were burned at the bottom. Two residents directly stated they would not eat the bread due to it being burnt, and another resident reported that burned food was a recurring issue, often leading them to forgo eating or request alternatives. These findings were based on direct observation, resident interviews, and review of medical records and care plans, which indicated that all affected residents were on regular diets and, in some cases, required assistance with meal setup or supervision. When the issue was brought to the attention of facility staff, the DON had no response regarding the burnt bread, and the Food Service Manager, who assisted with the meal, stated she did not notice any burnt bread or receive complaints. The facility's policy provided to surveyors referenced the Texas Food Establishment Rules. The deficiency was identified as a failure to provide food that was palatable and met the needs of each resident, as required.