|§483.60(d) Food and drink|
Each resident receives and the facility provides-
§483.60(d)(4) Food that accommodates resident allergies, intolerances, and preferences;
§483.60(d)(5) Appealing options of similar nutritive value to residents who choose not to eat food that is initially served or who request a different meal choice;
Based on review of facility policies, observation of dining and meal tickets, residents and staff interview, it was determined that the facility failed to provide food preferences for two of eight residents (Residents R18 and R72).
The facility policy, " Food Preferences" last reviewed May 2019, indicated that individual resident food preferences will be obtained in order to ensure resident meal satisfaction. These preferences are obtained upon admission, resident request and any changes in resident health status.
During an observation on 8/27/19, at 12:02 p.m. Resident R18 and Resident R72 told staff that their meals were not what they had ordered.
During observations of their meal ticket on 8/27/19, at 12:02 p.m. both tickets indicated a turkey cutlet and beef kabob. Each tray had a turkey cutlet, but no beef kabob. Resident R18 had indicated at the bottom of the ticket wanting grilled cheese and tomato soup, this was not provided to Resident R18. Resident R72 stated that no one had asked her what her preference was that she wanted a hot dog from the alternate menu.
During an interview on 8/27/19, at 12:18 p.m. Licensed Practical Nurse(LPN) Employee E7 stated that the facility failed to provide food preferences for Residents R18 and R72.
28 Pa. Code: 211.6(a) Dietary services.
| ||Plan of Correction - To be completed: 10/01/2019|
The two residents found to be affected by the deficient practice were served their food preferences immediately.
Residents who may potentially be affected by the deficient practice will be identified by the social service department, DON, and ADON who will interview facility residents to determine if their food preferences were provided.
The Dietary Manager and the Dietitian will visit the residents of the facility and review likes/dislikes, check the tray tickets, making necessary changes, and then notifying staff regarding the changes. The dietary staff will be educated by the dietary manager and the dietician on the importance of honoring residents' food preferences and ensuring that tray tickets match what is being served.
The Dietitian will meet with residents upon admission within the first 48 hours and note on the Food Preference Log the resident's likes/dislikes/preferences. The Dietary Manager will visit within the first week to ensure dietary Likes/Dislikes/Preferences are being followed. Any changes will be made to tray tickets on the same day, dietary staff informed of the changes, and noted on the Meal Round Log. Audits via resident interview and/or matching meal tray tickets of no less than six residents will be performed weekly by the dietary manager/dietician to ensure compliance with food preferences x 4, then monthly ongoing. If required, corrective action will be initiated. Corrective action will be monitored with the monthly Food Committee Meeting.
The Administrator or designee will monitor Meal Round Logs weekly for 1 month, monthly for 3 months, then quarterly thereafter. Results of the monitoring will be reviewed in the monthly QA meetings and in the Quarterly QAPI meetings.