R2 sat in the dining room eating pot roast, mashed potatoes and a dinner roll for lunch on December 21. Her plate had no vegetables. She told inspectors she wasn't served any vegetables because the only option was carrots, which she doesn't eat.
"There is no different vegetable," R2 said. "They used to have a whole list of things but they don't have that anymore. We eat what they bring us."
The facility's own policy requires alternatives to be "immediately available if the primary menu or selections for a particular meal are not to a resident's liking." But the Food Services Manager confirmed to inspectors that no alternate vegetables or starches were served with meals.
R23 told the Resident Council that the alternative menu "disappeared about a month ago." When she asked why, staff informed her it was too complicated for kitchen workers. R18 said the facility added one new alternative, but it was meaningless — "if they were being served a chop salad the alternative would be a Caesar salad or a hamburger for a hamburger."
Staff doesn't offer alternatives when residents want something other than the main meal, R18 said.
The Registered Dietician told inspectors she expected alternates of equal nutritive value to be available for each meal. She also expected menus to be posted where residents could access them. The Food Services Manager confirmed the Always Available Menu was supposed to be posted next to daily menus throughout the facility and in each resident's room.
Residents receiving special diets got no alternatives either, despite the facility's written policy promising immediate availability of meal choices.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Burlington Health and Rehabilitation Center from 2025-12-22 including all violations, facility responses, and corrective action plans.