F0803

E

Failure to Follow Menu, Portion Sizes, and Texture Requirements for Pureed and Mechanical Soft Diets

Hinsdale, Illinois Survey Completed on 01-08-2026

Penalty

No penalty information released

Summary

Surveyors identified a deficiency in the facility’s failure to follow prescribed menus, portion sizes, and texture modifications for pureed and mechanical soft diets. On a specified lunch date, the posted menu and corresponding menu spreadsheet for pureed diets required pureed fajita chicken to be served with a #10 scoop, pureed peppers and onions with a #8 scoop, pureed bread with a #16 scoop, and 4 oz of seasoned cream of rice. Scoop equivalents showed #10 = 3-3/4 oz, #8 = 4 oz, and #16 = 2-3/4 oz. Instead, the cook used a #12 scoop for both the pureed chicken and pureed rice and a #8 scoop for pureed refried beans, stating the facility did not have a #10 scoop and that he compensated by using a heaped #12 scoop. The cook also did not prepare the pureed tortilla as indicated on the menu spreadsheet. As a result, four residents on pureed diets received heaped #12 scoops of pureed chicken and rice and a #8 scoop of refried beans, rather than the specified portions and items on the menu spreadsheet.

For residents on mechanical soft diets, the menu spreadsheet required course ground chicken fajita with ground peppers and onions, served on bread, with the recipe directing that the prepared chicken fajita mixture be processed until no pieces were larger than 1/8 inch. Observations showed that the ground chicken mixture contained large onion pieces between 2–3 inches long that appeared crunchy, and this mixture was placed on a tortilla and served with Spanish rice and black beans to six residents on mechanical soft diets. The Regional Director of Operations acknowledged that the onion pieces should have been less than 1/8 inch and initially stated that tortillas are soft and that serving the mixture on bread would be odd. However, the facility’s mechanical soft diet policy, taken from the 2025 diet manual, specified that foods must be easy to chew, in bite-size pieces of 1/2 inch or less, with vegetables cooked to a fork-tender, mashable texture no larger than 1/2 inch, and explicitly listed tortillas as a food to avoid. The dietitian later confirmed that the recipe and policy for mechanical soft diets, as well as the specified scoop sizes for pureed diets, should have been followed to provide appropriate consistency and portions for the residents on pureed and mechanical soft diets.