Based on interview, observation and record review the facility failed to provide the mechanical soft diet texture as directed by the recipe for 8 of 15 residents (R1, R55, R31, R5, R58, R60, R39, R22) reviewed for dining in a sample of 67. Findings include: The Facility document titled, Diet Spreadsheet dated week 4, Day 23 documents: Dental Soft (Mech Soft) - Ground Italian Herbed Pork Loin with gravy, Cornbread stuffing with gravy, Brussel sprouts (d/s), and frosted cake. On 09/19/22 at 11:30 AM throughout lunch V6 (dietary aide) served Italian Herbed pork that was pulled apart pieces. The muscle fibers were pulling apart easily however, they were approximately 2 inches long. The meat was not mechanically altered. The Brussel Sprouts were not cut up for the mechanical soft diet. On 09/19/22 between 11:30 AM and 1:00 PM R1, R55, R31, R5, R58, R60, R39 and R22 were observed with and eating the mechanical soft textured diet for lunch that consisted of Ground Italian Herbed Pork Loin with gravy, Cornbread stuffing with gravy, Brussel sprouts (d/s), and frosted cake. On 09/21/22 at 2:20 PM, V13 (Speech Language Pathologist) stated, mechanical soft meat should be pieces of meat that are a few millimeters long in length. The meat should go through mechanical alteration. Any larger vegetables such as Brussel sprouts should also be cut up. The recipe card should list the procedure for the mechanical soft diet preparation. On 09/19/22 at 12:45 PM, V11 (Registered Dietician) stated, the facility should utilize the recipe card for the directions for the mechanically altered diet. On 09/19/22 at 12:40 PM, V5 (Dietary Manager) stated, the Ground Italian Herbed Pork Loin with gravy is the recipe for the mechanical soft diet Italian Herbed pork. The Brussel Sprouts (d/s) - dental soft is the recipe used for the mechanical soft diet Brussel Sprouts. The Ground Italian Herbed Pork Loin w/Gvy (Gravy) Day 23 lunch recipe documents: 5. Place needed number of servings into a clean and sanitized food processor and grind to the size and texture of fine hamburger. The Brussel Sprouts (d/s) Day 23 lunch recipe documents: 4. Chop brussel sprouts into bite-size pieces. Transfer to greased steam table pans. The undated document by the American Dietetic Association titled, National Dysphagia Level 2: Mechanically Altered Nutrition Therapy (provided by V13 (Speech Language Pathologist)) documents: Description: This level consists of foods that are moist, soft-textured, and easily formed into a bolus. Meats are ground or are minced no larger than one-quarter-inch pieces; they are still moist, with some cohesion. 1. R1's Physician order sheet dated 09/01/22 documents: Regular diet, mechanical soft texture with a start date of 06/20/22 and no end date documented. R1's Physician order sheet dated 09/01/22 documents: Speech Therapy Clarification: Diet change from pureed solids to mechanical soft solids. All food must be cut up/set up via staff. Use aspiration precautions: reduced bolus size for all PO (by mouth). Patient requires direct supervision for all PO (by mouth). R1's Minimum Data Set (MDS) section K dated 09/15/22 documents : Mechanically altered diet require change in texture of food or liquids with the yes checked. 2. R55's Physician order sheet dated 09/01/22 documents: Regular diet, mechanical soft texture with a start date of 03/25/22 and no end date documented. R55's Minimum Data Set (MDS) section K dated 08/25/22 documents : Mechanically altered diet require change in texture of food or liquids with the yes checked. 3. R31's Physician order sheet dated 09/01/22 documents: General diet, mechanical soft texture with a start date of 08/24/22 and no end date documented. R31's Physician order sheet dated 09/01/22 documents: Speech Therapy diet clarification: Diet change from regular solids, thin liquids to mechanical soft solids, honey thick liquids. Patient requires intermitted supervision from staff. Continued all other diet orders, with an ordered date of 08/22/2022. 4. R5's Physician order sheet dated 09/01/22 documents: General diet, mechanical soft texture with a start date of 11/15/21 and no end date documented. R5's Minimum Data Set (MDS) section K dated 07/01/22 documents : Mechanically altered diet require change in texture of food or liquids with the yes checked. 5. 58's Physician order sheet dated 09/01/22 documents: Low Concentrated Sweets diet, mechanical soft texture with a start date of 10/12/21 and no end date documented. R58's Minimum Data Set (MDS) section K dated 08/26/22 documents : Mechanically altered diet require change in texture of food or liquids with the yes checked. 6. R60's Physician order sheet dated 09/01/22 documents: Regular diet, mechanical soft texture with a start date of 03/21/22 and no end date documented. R60's Minimum Data Set (MDS) section K dated 08/29/22 documents : Mechanically altered diet require change in texture of food or liquids with the yes checked. 7. R39's Physician order sheet dated 09/01/22 documents: Regular diet, mechanical soft texture with a start date of 06/20/22 and no end date documented. R39's Minimum Data Set (MDS) section K dated 07/29/22 documents : Mechanically altered diet require change in texture of food or liquids with the yes checked. 8. R22's Physician order sheet dated 09/01/22 documents: Regular diet, mechanical soft texture with a start date of 10/26/21 and no end date documented. R22's Minimum Data Set (MDS) section K dated 07/07/22 documents : Mechanically altered diet require change in texture of food or liquids with the yes checked.