Survey of Dietetic Services in Selected Nursing Homes in Georgia and South Carolina

Dietetic services in selected nursing homes in Georgia and South Carolina were surveyed to determine if long-term care facilities were meeting Health, Education, and Welfare (HEW) standards for dietetic services and whether failure to meet established standards affected patient health. Eight of the 17 nursing homes surveyed did not meet the HEW standard for therapeutic diets, and six other facilities were not preparing and serving the diets as ordered by physicians. Noncompliance ranged from serving slightly more food than prescribed to serving basically the same meal to all patients even though calorie control diets ranged from 1,200 to 2,000 calories. The HEW Rapid Data Retrieval System showed that from 5.2 percent to 16.2 percent of skilled nursing facilities in individual States did not comply with therapeutic diet standards. Review of selected medical charts did not indicate that patients who were served incorrect therapeutic diets experienced health problems as a result. Improper therapeutic diets did not adversely affect the condition of diabetic patients either. One facility in Charleston, South Carolina, did not recognize or meet either the normal or therapeutic nutritional needs of its residents. The Region IV office should: require State survey agencies to place more emphasis on filling vacant nutrition consultant positions, assist State survey agencies in identifying reasons why long-term care facilities do not serve therapeutic diets correctly, and ensure that Margaret's Convalescent Center's participation in the medicaid program is terminated unless the home meets HEW standards.