Resident Selection and Adequate Nutrition (California)

During a pre-survey visit in a long-term care community, the RD was observing the lunch meal service. A resident was seen receiving only broccoli and no other food items on their tray. Concerned, the RD checked the tray card and realized that the resident had been given a selective menu from the CrandallMenu program, and the resident had only selected the broccoli.

As a corrective measure, the RD pulled Crandall Corporate Dietitians Policy 212 regarding the “Selective Menu” policies and procedures to review the guidelines with the Director of Dietary and their staff. The policy states:

To ensure adequate nutritional intake for the resident, the resident’s selections should be reviewed for appropriate nutrition and balanced diet selections by the Director of Food and Nutrition services, CDM, DTR, or other clinically qualified nutrition professional.

When the selections made do not provide adequate nutrition, the missing food groups should be provided along with the RD’s choices. A clinically qualified individual should counsel with the resident regarding proper nutrition choices.

The counseling should be documented, and care planned; however, ultimately the resident has the right to choose.

After the RD counseled with the CDM, the CDM met with the resident and reviewed how to choose a balanced diet. The resident agreed that they should choose a balanced meal and corrected only choosing one item.

See Crandall Policy 212 “Selective Menus”