Failure to Follow Puree Diet Portioning Procedure for Two Residents
Penalty
Summary
The deficiency involves failure to follow the facility’s pureed diet policy and procedure for determining appropriate portion sizes for two residents on a pureed diet. During a lunch meal observation, a dietary aide pureed Salisbury steak for two pureed-diet residents but did not measure the pureed meat in a volume measuring cup before service, contrary to policy. Instead, the aide transferred the pureed meat directly from the food processor to a serving dish on the steam table and selected a blue #16 scoop (2.66 oz) for serving, based on the assumption that the meat portion would be the same as the pureed cauliflower. The aide reported having placed two pieces of Salisbury steak into the food processor but did not calculate the final volume or determine the correct scoop size using the facility’s Pureed Diet Portion Sizes/Scoops chart. In contrast, the aide followed the required steps for the pureed cauliflower by pureeing it, transferring it to a measuring cup, obtaining the volume, and then using the chart to select the correct scoop size, which was identified as a #6 scoop (5.3 oz). Despite this, the aide used the same blue #16 scoop for both the cauliflower and the meat. After lunch service, the aide confirmed there was approximately half a serving of pureed cauliflower and about one full serving of pureed Salisbury steak left over, even though only two residents were on a pureed diet. The registered dietitian later confirmed that staff are expected to use the volume method and acknowledged that the aide did not measure the pureed meat and that there should not have been leftover pureed meat if the correct scoop size had been used. The facility’s written policy requires adding the correct number of servings to the processor, pureeing to proper consistency, measuring the final volume, using the chart to determine serving size, and labeling with serving size, steps that were not followed for the pureed meat.
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