Failure to Follow Physician-Ordered Therapeutic Diets
Penalty
Summary
The deficiency involves the facility’s failure to follow physician-prescribed diets for two residents reviewed for dietary services. For one resident with physician orders for fortified foods with each meal and ice cream with lunch and dinner, nursing staff reported that the facility did not keep ice cream in stock and that residents with orders for ice cream did not receive it. During a mealtime observation, this resident’s lunch tray did not include ice cream, despite the active order. Staff interviews confirmed that ice cream was only available if staff purchased it themselves and that residents with ice cream orders were not provided ice cream as ordered. Another resident, diagnosed with Alzheimer’s disease and anorexia, had physician orders for fortified foods with each meal and a finger food-focused diet. During a mealtime observation, this resident received the same meal as other residents, consisting of fish, noodles, cooked vegetables, and a roll, rather than finger foods. The resident used a fork to poke at the food and took a bite, but the ordered finger food-focused diet was not provided. An LPN stated that residents with orders for finger foods usually did not receive them and instead were given the same meal as everyone else. The DON reported there was no policy specific to following diet orders, but stated it was the policy to follow all physician orders.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.