F0803

C

Menus Failed to Ensure Adequate Fruits and Vegetables per Facility Standards

Gonzales, Texas Survey Completed on 01-28-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to provide residents with a nourishing, palatable, well‑balanced diet that met daily nutritional and special dietary needs, including adequate fruits and vegetables as outlined in its own nutrition resources. An anonymous complaint alleged that the facility did not serve a good variety of foods and that the food did not meet nutritional guidelines for each resident. During observation of a dinner meal, a requested sample tray did not include a fruit option from a dessert cart, and no dessert cart or staff passing out fruit to residents was observed during that dinner service.

Record review of the facility’s Fall/Winter 2025 menu showed that on multiple days (Days 6, 12, 14, 16, 20, 22, 25, and 30), the planned meals did not consistently provide the number of fruit and vegetable servings described in the facility’s Nutrition Care Manual, which called for 2.5 cups or more of vegetables and 2 cups or more of fruits per day, with at least half of fruits from whole fruit rather than juice. For example, Day 6 listed only one vegetable (sweet peas) and one fruit (juice) for the entire day, and other days relied heavily on items such as potatoes, cucumbers, and juice to meet fruit and vegetable expectations. The written menus did not document additional sources of fruits and vegetables such as snacks or dessert carts.

In interviews, the CDM stated she followed the menus approved by the contracted food company and the RD and questioned why some items like fruit were missing, but continued to follow the approved menus. The RD reported that potatoes and cucumbers were counted as vegetables on certain days and stated that they ensured five servings of fruits and vegetables per day, also indicating that fruit juice available all day, a dinner dessert cart with fruit, and snacks at the nurse’s station were counted toward residents’ fruit intake; however, these practices were not reflected on the written menus. The ADM stated his expectation that the purchased menus and RD approval ensured nutritional adequacy. The facility’s Dietary Services policy required menus to meet residents’ nutritional needs in accordance with recommended dietary allowances, but the cited National Research Council reference did not specify daily fruit and vegetable amounts for older adults, and the facility’s actual menus and documentation did not demonstrate compliance with the facility’s own Nutrition Care Manual standards for fruits and vegetables.