Failure to Follow Puree Food Preparation Guidelines and Recipes
Penalty
Summary
Surveyors identified a deficiency in the facility’s preparation of pureed foods for eight residents on puree or mechanical diets. The facility’s policy and guidelines for Puree Food Preparation required that pureed foods be prepared in a manner that conserves nutritive value, palatable flavor, and attractive appearance, and specified the type and amount of ingredients to be added to different food categories (such as broth or gravy for meats and poultry, margarine for noodles and root vegetables, mashed potato flakes for certain vegetables, and thickener for most fruits). During review, it was noted that the policy had been updated, and the Administrator stated that pureed foods should be prepared in accordance with recipes to present food integrity and nutritive value. During an observed puree food preparation session, a cook with five months’ tenure at the facility and five years’ experience as a cook prepared three pureed items: pulled pork, carrots, and baked beans, for eight residents receiving pureed diets. The cook did not have all supplies ready before starting, stopped production to retrieve beef base, and failed to perform hand hygiene before resuming preparation and between preparation of each pureed item. He used a sink to rinse utensils during the process, did not use a recipe, and did not measure ingredients to ensure appropriate consistency. When asked about the expected consistency, he described it as a “peanut butter consistency” and acknowledged he did not know where the recipes were located, while the Food Service Director clarified that recipe books were stored on a shelving unit near the puree preparation area.
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