• 64-14-9. Dietary Services.


9.1.a.  The licensee shall provide meals that are in substantial compliance with current Recommended Dietary Allowances of the Food and Nutrition Board of National Academy of Sciences, National Research Council, or as specified in this rule, except as ordered by a physician.  (Class II)


9.1.b.  The licensee shall ensure that each resident is offered at least three (3) freshly prepared meals seven (7) days a week, and also special diets and snacks that meet the resident’s needs and choices, as identified in his or her needs assessment. The meals shall provide a variety of foods as follows:


9.1.b.1.  Breakfast:  fruit or juice, cereal, whole-grain or enriched bread products, and Grade A vitamin D milk.


9.1.b.2.  Noon and evening meals: protein sources, such as meat, poultry, fish, eggs, cooked dried legumes, cheese or peanut butter; vegetables or fruit; whole-grain or enriched grain food products; and Grade A vitamin D milk.  (Class II)


9.1.c.  When therapeutic or modified diets are provided by the residence, the licensee shall maintain on file a physician’s order for each diet.  The licensee shall prepare therapeutic or modified diets, as ordered by the physician, according to written instructions that includes types and amounts of food to be served, obtained from the resident’s physician or a dietitian.  At no time shall a resident be offered less than one thousand four hundred (1,400) calories daily, unless specifically ordered by a physician.  (Class I)


9.1.d.  The licensee shall provide each resident  with the amount of food and fluid on a daily basis necessary to maintain his or her appropriate minimum average weight.  Staff shall weigh residents upon admission and monthly thereafter and document the resident’s weight in his or her record.  If staff notes an unplanned weight loss or gain of five (5) pounds or more in the resident’s record, the staff shall report it to the resident’s physician.  (Class III)


9.1.e.  The licensee shall encourage resident participation in menu planning and shall serve meals at times mutually agreed upon by residents in the assisted living residence with consideration of individual resident preferences.  (Class III)


9.1.f.  The licensee shall accommodate residents who are unable to eat at the planned mealtime and provide for a meal substitution if the resident does not tolerate or like the foods planned for the meal.  (Class II)


9.1.g.  The licensee shall maintain a daily record of actual foods served for each meal and vary the menu content.  (Class III)


9.1.h.  The licensee shall keep grocery receipts and records of actual food served to the residents on file in the assisted living residence for at least thirty (30) days.  (Class III)


9.1.i.  The licensee’s food service facilities shall comply with Division of Health rule, “Food Establishments,” 64CSR17.  (Class II)