HospitalInspections.org

Based on document review, interview and observation, the director of the food and dietetic services failed to ensure that patients had appropriate containers to eat food from, failed to provide condiments for regular diets, failed to ensure food was palliative in appearance and taste and failed to ensure an appropriate amount was prepared for each meal.

Findings include:

1. On 09-27-12 at 1420 hours, staff members #44, 45 and 46 indicated that patients who eat breakfast in the unit 422B were brought dry cereal in a small square area in a flat Styrofoam tray that could not hold milk.

2. On 09-27-12 at 1540 hours, staff #43 indicated that on 09-25-12 that staff brought a patient's breakfast tray that was delivered from dietary and it had dry cereal in a small square area in a flat Styrofoam tray that could not hold milk.

3. On 09-27-12 at 1540 hours, the type of flat Styrofoam tray that contained the dry cereal, presented by staff #43, was observed. The small square area measured 3 inches by 3 inches and 5/16th inches deep.

4. On 09-27-12 at 1130 hours, patient #3 indicated that when the contracted dietary service took over in 03/2012 that he/she decreased his/her intake of food due to the food having no flavor, tasting bland, appearance of food was not good and the dietary service took away salt. Patient #3 indicated that he/she lost weight due to him/her choosing not to eat meals provided by the contracted dietary service.

5. Review of patient #3's MR indicated the patient was on a regular diet and lost 18 pounds since 03/2012.

6. Review of facility documentation of monthly weights of patients for March 2012 to September 2012 indicated that 25 of 55 patients had weight loss of at least 5 pounds.

7. On 09-27-12 at 1150 hours, patient #1 indicated that when the contracted dietary service took over in 03/2012 that salt was no longer available for patients to use on meals, the food had no flavor and the appearance of the food in general was bad.

8. On 09-27-12 at 1055 hours, staff #43 indicated that when the contracted dietary service took over in 03/2012 that it used recipes from prison meals that used a lot of rice and beans. The vegetables prepared lacked seasoning, patients did not like the variety of vegetables, and patients thought the contracted dietary service was making wax beans, stewed tomatoes and casseroles too often. Some patients lost weight due to refusing to eat what was prepared by the contracted dietary service.

9. On 09-27-12 at 1200 hours, patient #10 indicated that patients are unable to get salt for meals.

10. On 09-27-12 at 1435 hours, staff #48 indicated that when he/she takes patients off campus to the store, that patients are buying salt shakers to use on their meals.

11. On 09-27-12 at 1500 hours, staff #49 indicated the contracted dietary service does not provide salt to the facility patients due to the Nutrition Guidelines it follows. These guidelines were requested and staff #46 confirmed that he/she did not have the guidelines.

12. On 09-27-12 at 1020 hours, staff #40 indicated that patients have been complaining about the quality and the quantity of food being provided by the contracted dietary service and on 09-27-12 at 1700 hours, staff #40 indicated that the facility has received 22 patient complaints about the dietary service in the last 2 months and received approximately double the 22 in the previous 2 months.

13. On 09-27-12 at 1220 hours, a food tray that patients were receiving was observed and sampled. The appearance of the baked beans was not appealing and the taste of the baked beans was bland. On the dining room table was black pepper and Ms. Dash seasoning, but no salt was available. The beans were sprinkled with the black pepper and Ms. Dash, then another spoon of baked beans was tried and could not be eaten. It was observed that at least 5 patients were disposing of their food trays with baked beans still on the tray.

14. On 09-27-12 at 1420 hours, staff #44, 45 and 46 indicated that each used to eat meals at the facility, but will not eat meals prepared by the contracted dietary service due to the taste and appearance of the meals.

15. On 09-27-12 at 1400 hours, patient #11 indicated that there have been patients who have not received the main entree due to not enough made and the patients had to eat a cheese sandwich, or a peanut butter & jelly sandwich or a substitute if available.

16. On 09-27-12 at 1420 hours staff # 44, 45, 46 and 47 indicated that some patients on unit 422B have not received the main entree 2-3 times per week due to the dietary service not preparing enough main entrees.

17. On 09-27-12 at 1610 hours, on the unit 422B, the following was observed on the dinner food trays delivered:
a strap was around the dinner trays causing 1 of 5 milk containers and 2 juice containers to be leaking on the dinner trays.