In an assisted living annual survey, a surveyor cited a community for inaccurately following recipes and failure to follow diet orders for residents who had orders for a thickened liquid consistency. During meal service, the surveyor observed soup served to two different residents. One resident was on a puree diet with nectar thick liquids and was served plain broth, the liquid of the soup was thin. The other resident was on a mechanical soft diet with nectar thick liquids and was served the soup that was prepared for the regular diet and was also thin in consistency. Upon further discussion with the cooks, the surveyor was informed that all soups were thickened with corn starch. The surveyor asked to see the soup recipe and corresponding spreadsheets.
The recipe stated for residents who have an order for a thickened liquid consistency, the soup should be prepared to a puree consistency, following the puree recipe. There was also guidance on the recipe for thickening the puree soup to the correct ordered consistency for individuals requiring thickened liquids. The puree recipe specified that a commercial food thickening agent, in a specific quantity, should be utilized. Corn starch was not noted in the recipes as an ingredient nor as an appropriate thickening agent. The correct procedure for this process was for the soup to be prepared per the instructions on the recipe, puree recipe, and spreadsheet following the specified amount of commercial thickening agent to achieve the nectar thick consistency.