Failure to Accommodate Food Allergy
Penalty
No penalty information released
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Summary
The facility failed to accommodate a resident's documented food allergy. Clinical record review showed that a resident with dementia and depression had a documented pineapple allergy in both her ongoing plan of care and admission documentation. Despite this, on December 21, 2025, the resident was served Hawaiian Ham with pineapple sauce, as listed on the posted menu for that day. Facility investigation confirmed that the resident ingested some of the pineapple sauce. The allergy was noted on the resident's meal ticket, but staff did not follow this information. The DON confirmed in an interview that staff should have adhered to the allergy information provided on the meal ticket and not served the pineapple sauce.