Failure to Provide Palatable and Attractive Meals
Penalty
Summary
The deficiency involves the facility’s failure to prepare and serve food and beverages that are palatable, attractive, and consistent with its own policy on food palatability and temperature. The facility census showed that 106 residents consumed food from the kitchen. Cognitively intact residents with multiple medical conditions, including one with rhabdomyolysis, lumbar spine fusion, inflammatory spondylopathy, type 2 diabetes with neuropathy, malnutrition, COPD, and major depressive disorder, and another with trigeminal neuralgia, type 2 diabetes, hypertension, and osteoarthritis, reported that the food was terrible, barely edible, nasty, and often caused them to avoid the entrée. One resident stated that the food tasted bad and looked bad, and that many other residents disliked the food but could not speak up due to dementia or impaired cognition. Staff interviews corroborated frequent resident complaints about the food. A CNA reported that residents complained almost every day that the food did not taste good or was cold, often leaving food on trays or requesting alternative items such as sandwiches. An LPN stated that residents complained that they did not like the food, that it did not taste good, or that they did not receive the meals they ordered. Another LPN who no longer worked at the facility recalled daily complaints that the food looked gross, lacked taste or seasoning, and was too bland. Resident council minutes documented concerns about specific items such as grits needing to be cooked longer and a desire for vegetables on sandwiches. Direct observations of meal preparation and service showed unappetizing and inconsistent food presentation. Dessert cups of peaches had a small dollop of whipped cream that was smashed into the plastic wrap, causing about half of the topping to adhere to the plastic. A large portion of a cornbread pan was burnt and not used, and no replacement cornbread was prepared, resulting in at least six residents receiving plain wheat sandwich bread instead of the menu item. Pureed bell peppers, carrots, and cornbread appeared thick, lumpy, and unappetizing; the pureed carrots had a gelatinous, shiny texture that the dietary manager later stated was not appropriate, as pureed carrots should resemble mashed potatoes. A test tray provided to surveyors contained corn, a plain piece of bread, and an unidentifiable rice/meat mixture in tomato sauce on a Styrofoam plate wrapped in plastic, with the cook acknowledging that the facility had run out of stuffed peppers, cornbread, and spiced peach dessert, and that the rice/meat mixture was the inside of the stuffed pepper used for mechanical soft diets. The administrator agreed that the test tray did not appear appetizing or palatable.
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