Failure to Offer Menu Alternatives on Weekends
Penalty
Summary
The deficiency involves the facility’s failure to consistently provide menu alternatives and substitutions on weekends, despite policies stating that residents may choose foods they wish to have and that an alternative menu is available daily. Multiple cognitively intact residents reported that from Monday through Friday, activity staff visit units to review the day’s lunch and dinner options and offer a list of alternative items, which are then communicated to the kitchen. However, these residents stated that this process does not occur on weekends and that they are only served the posted menu items on those days. Several residents described that on weekends they are unable to obtain substitutions if they do not like the main entrée. One resident stated that CNAs tell him the kitchen does not do substitutions on weekends, so he must eat what is served. Another resident reported he can only get substitutions during the week and wishes weekend options were available for variety. A different resident stated that while he can order ahead and receive substitutions Monday through Friday, on weekends staff tell him there is no other food to give him if he dislikes the meal, resulting in him going hungry. Another resident reported that on weekends he has to eat whatever is served because no substitutions are available, and another said that when he does not like the weekend meal, he calls his family for money to buy snacks or order outside food so he has something to eat. Staff interviews confirmed that the practice of offering and documenting menu alternatives occurs only on weekdays. A dietary aide stated that substitutes are available Monday through Friday but not on weekends, and that any weekend changes depend on what food happens to be available. Activity aides reported that they solicit residents’ meal choices and offer alternatives only during the week, not on weekends, and that on weekends residents receive only the posted menu entrée. In contrast, the regional food service manager and dietary manager both stated that menu alternatives are supposed to be available and offered every day at every meal, consistent with facility policies and an “Always Available Menu” listing items such as cheeseburgers, hamburgers, grilled cheese, peanut butter and jelly, deli sandwiches, and chef salad. The discrepancy between stated policy and actual weekend practice led to residents not being offered menu alternatives on weekends.
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