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Complaints About Dietary Services Case

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Nutrition
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Case Study
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Chapter 11
Case 2
Complaints About Dietary Services
Contributed by Cindy K. Manjounes, MHA, EdD, Lindenwood University.
Complaints from residents have started to surface regarding availability and selection of items on
the menu. Residents on restricted diets as well as vegetarians have limited choices. The facility
offers a nonselective menu, but, to the extent possible, accommodations are made. Recently,
meal hours have been reduced because of staff shortages in the dietary department. The
administrator was invited to this month’s resident council meeting in which some residents
became emotional, and the council’s president stated, “We used to look forward to meal times,
but things have gone downhill. The hours have been cut and we are rushed through the meals.
Some of us are thinking about moving to another facility even though we like the nurses here.
They are really caring. We have heard that the home has a new food service manager. This
person needs to straighten things out before we all leave.” Attendance in the dining room has
dropped because residents have started to request in-room meal delivery so they can take the
time to eat their meals. Some CNAs have been grumbling about the extra work they have to do
to deliver meals and pick up afterwards.
Questions
1. Identify the main issues that need to be addressed. What may have caused these problems?
2. Prioritize the issues based on their potential impact on the residents, staff, and the facility.
How should the administrator go about addressing the issues?

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The main issues to be addressed and cause of the problems
The main issues to be addressed are: the availability and selection of items in the menu
especially for residents on restricted diets and vegetarians who are only limited to choice of
items on the menu, meal hours that has been reduced as a result of shortages in the dietary
department where the residents are being rushed through the meals. Some residents have even
abandoned the dining hall and started to request in-room meal delivery so that they can get
sufficient time to take their meals. Dining plays a critical role in a resident’s quality of life
because most residents look forward to mealtime. A satisfying experience can also improve
clinical outcomes through better nutrient intake. The extra work that has been added to the CNAs
to deliver meals at different point and picking them up afterwards has to be addressed.
Dining rooms are essential for the residents as the dieticians and service managers who
routinely walk in the dining rooms during meal time can gather a lot of information by simply
talking to them. Such observation can reveal, among other things, which menu items are well
accepted, whether the food presentation is attractive, whether personal food preferences are
respected, whether diet orders are being followed, and whether portion control standards are
adhered to. Similarly, the nursing staff should ensure that patients are properly positioned while
eating. Inappropriately positioned patients can aspirate, experience difficulty eating, or get tired
and frustrated.
How the administrator should address the issues in order of their priorities
The administrator should prioritize these issues depending on their overall impact to the
residents, staff and the facility. The administrators should first dress the issue of meal hours
because the residents need quality time to take their meals. Failure to give them sufficient time
might force most of them to quit the facility. This will ensure that all the residents take their

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Chapter 11 Case 2 Complaints About Dietary Services Contributed by Cindy K. Manjounes, MHA, EdD, Lindenwood University. Complaints from residents have started to surface regarding availability and selection of items on the menu. Residents on restricted diets as well as vegetarians have limited choices. The facility offers a nonselective menu, but, to the extent possible, accommodations are made. Recently, meal hours have been reduced because of staff shortages in the dietary department. The administrator was invited to this month’s resident council meeting in which some residents became emotional, and the council’s president stated, “We used to look forward to meal times, but things have gone downhill. The hours have been cut and we are rushed through the meals. Some of us are thinking about moving to another facility even though we like the nurses here. They are really caring. W ...
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