| 36 |
REGENCY GRESHAM NURSING & REHAB CENTER |
385015 |
5905 SE POWELL VALLEY RD |
GRESHAM |
OR |
97080 |
2019-05-06 |
806 |
D |
0 |
1 |
9QV111 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, it was determined the facility failed to honor food preferences for 3 of 9 sampled residents (#2, 26, 48) reviewed for food concerns. This place residents at risk for unintended weight loss and decreased quality of life. Findings include: 1. Resident 48 was admitted in 12/2017 with [DIAGNOSES REDACTED]. An 11/9/18 Dietary Profile Assessment noted the resident did not like cooked vegetables. The 12/20/18 Cognitive Loss/Dementia CAA identified the resident was able to verbally communicate with others and made her/his needs known. Resident 48 advocated for her/himself and was involved in care decisions. A 3/13/19 Dietary Profile Assessment identified the resident received chef salads each lunch, but had no food items which she/he disliked. At the time of the survey, the resident's meal card (which identified diet orders and resident preferences on the meal tray) showed Resident 48 received a controlled carbohydrate diet with no added salt and no allergies [REDACTED]. In interviews on 4/30/19 at 11:52 AM and 5/6/19 at 11:16 AM, Resident 48 stated she/he hated cooked vegetables but was getting tired of the chef salads she/he had requested. The resident also voiced concerns about the small portions served of the main course which left her/him unsatisfied with the meal. When interviewed on 5/2/19 at 9:08 AM, Staff 36 (Kitchen Staff) stated staff did not always have sufficient food ingredients to serve all residents the same menu or to provide additional servings when residents requested. Frequent food substitutions were made. In a 5/6/19 interview at 9:36 AM, Staff 28 (CNA) stated Resident 48 often asked for more food. Staff 28 could generally offer cottage cheese, sandwiches or if available, more of the main course. The resident complained about the small main course portion the previous night which consisted of two small pieces of meat and onions. When interviewed on 5/6/19 at 12:28 PM, Staff 30 (Dietary Manager) stated when a resident identified a food dislike during the Dietary Profile Assessment, it would be reflected on the assessment and added to the meal card. Staff 30 was unaware of Resident 48's dislike of cooked vegetables and stated new dinner menus had resulted in small portions at the previous night's dinner. Additional vegetables and rice were going to be added to the dinner recipe in the future. 2. Resident 26 was admitted to the facility in 1/2019 with [DIAGNOSES REDACTED]. Upon admission, a therapeutic diet was ordered to address Resident 26's kidney disease. The diet order was revised on 2/1/19 to include Resident 26's preference to receive soy milk over regular milk. A 4/24/19 Dietary Profile indicated Resident 26 reported liking fruit, but did not like fish. Resident 26's care plan and Kardex (CNA care plan) did not include resident food preferences. On 4/30/19 at 12:06 PM, Resident 26 was observed with an untouched plate of food that included fish. Resident 26 stated she/he told the facility she/he did not eat fish and was tired of rice. Resident 26 ate a bag of candy and stated she/he would not ask for an alternative meal. Resident 26's meal card did not identify fish as a dislike. On 5/2/19 at 11:58 AM, Staff 33 (CNA) delivered a meal tray to Resident 26's room. Staff 33 reported Resident 26 received fish as the main dish. On 5/2/19 at 12:02 PM, Resident 26 was observed dining in her/his room. Resident 26's meal included fish, cooked zucchini, cooked corn, a dessert, a glass of soy milk. When asked about the meal, Resident 26 complained about having fish again and did not like the zucchini. Resident 26 ate the corn and took two bites of the fish, made a disapproving sound and pushed the plate away. Resident 26 proceeded to eat the dessert and drink the soy milk. Resident 26's meal card did not identify fish as a dislike. 5/3/19 at 3:59 PM, Staff 31 (CNA) reported if a resident had a food preference, it would be on the resident's meal card and sometimes on the Kardex. Staff 31 reported Resident 26 had not mentioned food preferences to him. 5/6/19 at 9:42 AM, Staff 32 (CNA) stated if a resident had a food preference, she/he would tell the nurse or the dietitian. Staff 32 reported the preference had to be on the meal card, because it was used to prepare the resident's tray and if it was not on there, it would not get done. 5/6/19 at 1:02 PM, Staff 30 (Dietary Manager) reported food preferences must be transferred to the meal card and verified this was not done for Resident 26. 3. Resident 2 was admitted to the facility in 1/2019 with [DIAGNOSES REDACTED]. admission orders [REDACTED]. Dietary Profiles dated 1/4/19 and 4/4/19 indicated Resident 2 reported disliking fish. Resident 2's diet meal card dated 5/6/19 listed cottage cheese and hard boiled egg as food preferences. In an interview on 4/30/19 at 10:16 AM Resident 2 reported weight loss because she/he preferred not to eat certain foods. Resident 2 reported the kitchen served her/him cottage cheese at lunch every day but she/he had not received hard boiled eggs with dinner as one of her/his requested food preferences. On 4/30/19 at 12:15 PM Resident 2 was served a plate of food which included fish. In an interview on 5/2/19 at 11:00 AM Staff 39 (CNA) reported the CNAs were responsible to ensure residents food requests and food preferences were communicated to the kitchen but the kitchen did not always have the food. On 5/2/19 at 12:04 PM Staff 40 (CNA) delivered a meal tray with fish as a main coarse to Resident 2. Resident 2 told Staff 40 she/he only wanted the cottage cheese and a beverage. Resident 2's meal card did not identify fish as a dislike. In an interview on 5/6/19 at 2:25 PM Staff 30 (Dietary Manager) reported the CNAs were responsible for submitting residents food requests and stated she was new and just learning the computer system. |
2020-09-01 |