Failure to Provide Ordered Pureed Diet Consistency
Penalty
Summary
The deficiency involves the facility’s failure to provide food in the prescribed texture and consistency according to a physician’s diet order for one resident. The resident had multiple diagnoses, including Alzheimer’s disease, atrial fibrillation, GERD, hypertension, spinal stenosis, aphasia following cerebral infarction, and glaucoma, and was documented on the MDS as moderately cognitively impaired and requiring setup assistance with meals. The physician’s order specified a pureed texture diet with moderately thick (honey) liquids. During a lunch meal observation, the resident was served pureed meat, peas, and carrots, but the pears with whipped topping appeared diced rather than pureed. A CNA was observed sitting next to the resident and cutting the pears with a butter knife, and when asked if the pears were pureed, the CNA stated they were. At the surveyor’s request, the CNA placed a scoop of pears on a spoon, which showed visible chunks of pear that the CNA continued to leave for the resident. The resident was then observed reaching into her mouth and placing a piece of pear onto her plate. The Food Services Supervisor later stated that a pureed diet should be the consistency of baby food and that there should not have been any chunks in the pears. The facility’s Menus and Meal Service policy documented that guest tickets should be printed for each resident at every meal to ensure diet accuracy and that a system needs to be established to ensure each resident receives their food at every meal.
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