Failure to Follow Approved Pureed Diet Menu and Recipes
Penalty
Summary
The facility failed to follow the approved dietitian menu for two residents on pureed diets. Observations revealed that instead of receiving the prescribed portions of pureed vegetable chili and pureed cornbread, the residents were served a 4-ounce scoop of chili and a 4-ounce scoop of pureed greens, with no pureed cornbread or bread provided. The pureed chili served did not contain vegetables as required by the recipe, resulting in a different appearance and composition compared to the regular chili. The staff member responsible for meal preparation admitted to omitting the vegetables to improve taste and used the incorrect scoop size due to a misunderstanding of the menu instructions. Additionally, the omission of pureed bread was attributed to the unavailability of premade pureed bread, which could not be ordered due to a cost increase. The Certified Dietary Manager confirmed the deviations from the menu, including the absence of a pureed bread option and the incorrect scoop size for the chili. The Registered Dietitian also verified that the menu and recipes were not followed, emphasizing that the pureed bread and correct portion sizes should have been provided, and that the pureed chili should have included vegetables as per the approved recipe. The residents involved had diagnoses of dysphagia, with one also on hospice care and experiencing weight loss, and both had physician orders specifying pureed diets tailored to their medical needs.