F0803

F

Failure to Follow Approved Menus and Portion Sizes for Breakfast Service

Cincinnati, Ohio Survey Completed on 02-23-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to follow the planned menu and dietary spreadsheets, including required portion sizes, for multiple residents. On the specified breakfast date, the approved menu called for cereal, toast, and sausage egg bake for residents on regular textured diets, and the dietary spreadsheet specified that all diets were to receive six ounces of cereal, with some diets requiring specific hot cereals. Another spreadsheet for a different date indicated that all diets were to receive a #16 scoop (two ounces) of scrambled eggs when scrambled eggs were on the menu. During observation of breakfast service, surveyors noted that the steam table contained pureed eggs, pureed toast, scrambled eggs, sausage patties, and toast, but no sausage egg bake. For residents on regular diets, the dietary staff member used a four-ounce scoop of scrambled eggs, served one sausage patty, and one slice of toast per plate, and for residents on pureed diets, served a three-ounce scoop of pureed eggs, a two-ounce scoop of pureed toast, and an insulated bowl of hot cereal.

Further observation showed that hot cereal was served directly from a pan on the stove using a slotted spoon, with two scoops placed into an insulated bowl, filling it only about halfway, and later a single scoop was served onto a divided plate along with pureed eggs and pureed toast. The dietary staff member confirmed he was using a four-ounce scoop for scrambled eggs and a three-ounce scoop for pureed eggs, and acknowledged that the portion sizes did not match the dietary spreadsheets. He also stated he had always substituted scrambled eggs and the corresponding breakfast meat when casseroles or similar items were on the menu, citing that several residents did not eat pork. The dietary manager confirmed that the egg bake was not prepared because about half of the residents did not eat pork, acknowledged that casseroles and similar items on the menu were routinely replaced with scrambled eggs and the associated breakfast meat, and verified that the hot cereal was not measured and that substitutions had not been discussed with the registered dietitian. The registered dietitian stated her expectation that menus and spreadsheets be followed as planned and that she should be consulted for menu changes, and indicated that the egg bake should have been provided as planned with alternate selections for residents who do not eat pork. The facility identified two residents who did not receive food from the kitchen, and the deficient practice had the potential to affect 76 residents in the facility.