Failure to Provide Ordered Double Vegetable Portions
Penalty
Summary
The deficiency involves the facility’s failure to provide residents with proper portion sizes as ordered, in accordance with its own menu and nutrition policies. The facility’s Healthcare Services Group policy titled “Menus” states that menus will be planned in advance to meet residents’ nutritional needs, will use standardized recipes and nutrient analysis, and will be served as written unless substitutions are made and logged. Despite this, surveyors found that residents were not consistently receiving the ordered portions, specifically related to extra vegetable servings. Resident #91 had a diet order written for a consistent carbohydrate diet with regular texture, thin liquids, double vegetable portions, and large portions for breakfast. On review of the resident’s diet tray ticket on one observation date, the ticket did not specify double vegetable portions, and the resident had already finished the meal, so the actual portions could not be verified. On another observation date, the tray ticket again did not specify double vegetable portions, and the resident was observed receiving three potato wedges, the same amount as other residents, rather than an increased portion. The Dietary Manager acknowledged that orders for extra portions should appear on tray tickets so dietary staff are aware, and stated that this resident’s tray tickets previously included instructions for extra portions but no longer did, without knowing why this change occurred.
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