Failure to Honor Resident’s Stated Food Preferences and Update Dietary Care Plan
Penalty
Summary
Facility staff failed to ensure that a resident’s dietary needs and preferences were updated and incorporated into the care plan. The resident, admitted with s/p joint replacement surgery, T2DM, and depression, had intact cognition and was able to communicate needs clearly. The active diet order indicated a controlled carbohydrate diet with regular texture, and the care plan noted nutritional problems related to the resident’s diagnoses with an intervention for the RD to evaluate and make diet change recommendations as needed. The facility’s policy required that individual food preferences be assessed upon admission or within 24 hours, communicated to the IDT, and documented in the care plan, with modifications to diet ordered with the resident’s or representative’s consent. The resident reported having told staff numerous times that she wanted a big bowl of salad for lunch every day because she believed the facility’s food was unhealthy, and also stated she had repeatedly requested copies of the weekly menu but had never received them. The CDM acknowledged that the resident wanted a big salad daily, stated this had been verified with the RD and Chef, and reported that the resident had been receiving the big salad every day and that menus could easily be provided. However, observation of the resident’s lunch tray showed a cranberry drink, black bean soup, fresh fruit, and a turkey and Swiss sandwich with pasta salad and lettuce and tomatoes on the side, rather than the requested big bowl of salad. The RD later confirmed awareness of the resident’s preference for a daily big salad at lunch but stated not being aware that the resident had not consistently received it. The report also notes that the failure to address the resident’s dietary requests in a timely manner had the potential for weight loss due to decreased consumption and/or anger/depression when requests were not met.
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