F0800

E

Failure to Ensure Adequate Pureed Diet Nutrition During Power Outage

Girard, Ohio Survey Completed on 03-23-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to ensure residents received a nourishing, palatable, well‑balanced diet that met daily nutritional and special dietary needs during a prolonged power outage. The facility experienced a power outage from the evening of 03/13/26 until the morning of 03/15/26, during which only the gas stove functioned in the kitchen because there were no generator-connected (red) outlets. As a result, staff could not use the food processor to prepare pureed foods and instead served items that could be made with boiling water. Dietary staff reported that residents on pureed diets were given mashed potatoes, stuffing, tomato soup, and cream of wheat, and no record was kept of the specific foods served during this period. Tray tickets for affected meals did not indicate what foods were actually provided.

Four residents with orders for pureed diet textures were specifically reviewed. One resident had dementia, type 2 diabetes mellitus, dysphagia oral phase, and was care planned as at risk for nutritional decline, with interventions including pureed diet with thickened liquids and house supplements twice daily. Another resident had protein calorie malnutrition, muscle wasting and atrophy, diverticulosis, and a history of significant weight loss, and was also care planned for pureed texture and house supplements twice daily. A third resident had dysphagia oropharyngeal phase, respiratory failure, intellectual disabilities, adult failure to thrive, and was ordered a pureed diet with nectar thick liquids and a daily house supplement. The fourth resident had COPD, GERD, mild cognitive impairment, major depressive disorder, significant weight loss, and was ordered a pureed diet with nectar thick liquids, Magic Cup with meals, and house supplements with meals for weight loss.

For all four residents, review of progress notes, nurse aide intake tracking, and MARs showed no documentation that any additional supplementation beyond the routinely scheduled supplements was provided during the power outage dates. Dietary staff, including the Dietary Supervisor and Dietary Director, were unable to identify what protein sources were served to residents on pureed diets during this time. A DTR and a Regional RN asserted that residents on pureed diets received nutritional supplements and that items such as tomato soup provided some protein, but the RD could not confirm whether additional supplementation was actually provided during the outage. One cognitively intact resident reported not getting enough to eat during the outage and stated that, although some food was provided, it was not enough to satisfy hunger and no additional items like ice cream or health shakes were offered. The DON confirmed that tray tickets did not specify what foods were served during the power outage, and there was no documentation to substantiate that residents on pureed diets received balanced meals or adequate protein during this emergency period.

The deficiency affected four reviewed residents with pureed diet orders and had the potential to affect all eight residents in the facility who required pureed diet textures. The lack of a system to ensure well‑balanced, nutritionally adequate pureed meals during the power outage, combined with the absence of documentation of what foods and supplements were actually provided, led to the finding that the facility did not meet the requirement to provide each resident with a diet that met daily nutritional and special dietary needs during the emergency event.