F0803

F

Failure to Use Menus With Defined Portion Sizes for Regular, Mechanical Soft, and Pureed Diets

Smyrna, Delaware Survey Completed on 01-09-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to use menus that included portion sizes for regular, mechanical soft, and pureed diets for two observed meals. Review of the week-two Spring 2025 menus showed they did not include portion sizes for these diet types, and individual residents’ pre-selected menu sheets for lunch on 01/06/26 and 01/07/26 also lacked portion sizes. A diet type report showed multiple residents on regular, mechanical soft, and pureed diets. During observations of the tray line on the 200 unit on both days, a food service worker plated meals by reading residents’ pre-selected menus without any portion sizes listed and without using any other menu to determine portions. The worker stated he relied on a list of portion sizes kept in the main kitchen.

The Dietary Manager confirmed that portion sizes were not included on the facility’s week-two Spring 2025 menus or pre-selected menus and provided a “Standard Serving Sizes” list that contained only generalized food groups and did not address mechanical soft or pureed foods. The Registered Dietitian stated she was not aware that menus without portion sizes were being used and acknowledged the requirement for menu portion sizes. When actual servings on 01/06/26 and 01/07/26 were compared to the week-two Spring 2025 menus with portion sizes, multiple items, including roasted potatoes, pureed salmon, pureed soup, pureed stuffed pasta shells, pureed asparagus, mechanical soft roast beef, rice, pureed roast beef, baked potatoes, asparagus, and regular soup, were found to have been served in amounts less than the specified portions or without a measurable portion. The facility also reported that it did not have a policy for menus.