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Based on observation, interview, and record review, the hospital failed to ensure the hospital's diet manual reflected diets served in the hospital.

Findings:

According to Registered Dietician A, the hospital utilizes both an online and paper diet manuals. The online diet manual was the American Dietetic Association Care manual. The hard copy (paper) manual was not a printed version of the online manual. The paper diet manual included information on some of the diets served. Neither manual reflected all the diets provided in the hospital.

According to an undated document titled "Diets Available in Medi-tech", the hospital physician could order among other diets a Hepatic Diet. Review of the diet manual did not include the description of the hepatic diet. In addition, the kitchen did not have a hepatic diet menu.

There had been modifications made to the hospital menu that had been approved by the medical staff. These modifications were not reflected in the description of the diet. For example, a nutritional supplement had been added to the clear liquid diet to improve the nutritional content of the diet. The approval was a document added to the manual. Nursing and food service staff that are not familiar with the modification that was made would not get an accurate description of the diet if the diet manual is being used as a reference source.