Dinners served!
As many operators of ALFs are aware, the culinary program can be the bane of your existence. Food quality or they lack thereof is one of the most common complaints from residents and families. The dietary program is a difficult arena because you are balancing so many different things. There is the health code for restaurants, resident’s personal food preferences and the operational aspect of providing those meals. While the facility may not be considered a ‘4-star Michelin restaurant’ you can rest assured following the following regulations, provided by the West Virginia Office of Healthcare Facilities Licensure & Certification, will keep you in the clear for any potential issues with state surveyors:
- 64-14-8. Dietary Services.
8.1. 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)
8.2. The licensee shall ensure that each resident is offered at least three freshly prepared meals seven 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:
8.2.1. Breakfast: fruit or juice, cereal, whole-grain or enriched bread products, and Grade A vitamin D milk.
8.2.2. 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)
8.3. 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 dietician. At no time shall a resident be offered less than 1,400 calories daily, unless specifically ordered by a physician. (Class I)
8.4. 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 the staff notes an unplanned weight loss or gain of five pounds or more in the resident’s record, the staff shall report it to the resident’s physician. (Class III)
8.5. 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)
8.6. 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 III)
8.7. The licensee shall maintain a daily record of actual foods served for each meal and vary the menu content. (Class III)
8.8. 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 30 days. (Class III)
8.9. The licensee’s food service facilities shall comply with Bureau for Public Health rule, “Food Establishments,” W. Va. Code R. §§64-17-1, et seq. (Class II)
10.4. Dining Area and Leisure Area.
10.4.1. The residence shall have a dining area of at least 15 square feet per resident. (Class III)
10.4.2. The residence shall have an area of at least 15 square feet per resident for leisure space that is equipped for reading and recreational purposes. The leisure area shall have furniture that provides good lower back support, arm rests, and that is clean, odor free, and in good repair. (Class III)
10.4.3. The dining room may serve as part of the leisure room. A combined dining and leisure room shall have a minimum of 30 square feet per resident. (Class III)
Top Takeaways:
- 2.1. Breakfast: fruit or juice, cereal, whole-grain or enriched bread products, and Grade A vitamin D milk.
8.2.2. 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)
OHFLAC does a good job spelling out exactly what is required for each meal to ensure you are meeting their requirements. It is up to your team to determine how creative you will be with the menu selections.
- 3. When therapeutic or modified diets are prWritten By: Michael Vannucci4/28/21
Title: Dinners served!
As many operators of ALFs are aware, the culinary program can be the bane of your existence. Food quality or they lack thereof is one of the most common complaints from residents and families. The dietary program is a difficult arena because you are balancing so many different things. There is the health code for restaurants, resident’s personal food preferences and the operational aspect of providing those meals. While the facility may not be considered a ‘4-star Michelin restaurant’ you can rest assured following the following regulations, provided by the West Virginia Office of Healthcare Facilities Licensure & Certification, will keep you in the clear for any potential issues with state surveyors:
- 64-14-8. Dietary Services.
8.1. 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)
8.2. The licensee shall ensure that each resident is offered at least three freshly prepared meals seven 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:
8.2.1. Breakfast: fruit or juice, cereal, whole-grain or enriched bread products, and Grade A vitamin D milk.
8.2.2. 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)
8.3. 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 dietician. At no time shall a resident be offered less than 1,400 calories daily, unless specifically ordered by a physician. (Class I)
8.4. 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 the staff notes an unplanned weight loss or gain of five pounds or more in the resident’s record, the staff shall report it to the resident’s physician. (Class III)
8.5. 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)
8.6. 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 III)
8.7. The licensee shall maintain a daily record of actual foods served for each meal and vary the menu content. (Class III)
8.8. 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 30 days. (Class III)
8.9. The licensee’s food service facilities shall comply with Bureau for Public Health rule, “Food Establishments,” W. Va. Code R. §§64-17-1, et seq. (Class II)
10.4. Dining Area and Leisure Area.
10.4.1. The residence shall have a dining area of at least 15 square feet per resident. (Class III)
10.4.2. The residence shall have an area of at least 15 square feet per resident for leisure space that is equipped for reading and recreational purposes. The leisure area shall have furniture that provides good lower back support, arm rests, and that is clean, odor free, and in good repair. (Class III)
10.4.3. The dining room may serve as part of the leisure room. A combined dining and leisure room shall have a minimum of 30 square feet per resident. (Class III)
Top Takeaways:
- 2.1. Breakfast: fruit or juice, cereal, whole-grain or enriched bread products, and Grade A vitamin D milk.
8.2.2. 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)
OHFLAC does a good job spelling out exactly what is required for each meal to ensure you are meeting their requirements. It is up to your team to determine how creative you will be with the menu selections.
- 3. 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 dietician. At no time shall a resident be offered less than 1,400 calories daily, unless specifically ordered by a physician. (Class I)
If your facility decides to provide special therapeutic diets, you must have a physician’s order on file for every resident who is requiring one. Keep this in the resident’s healthcare file as well as in the dietary files to ensure you are covered.
Pro Tip:
- Ensure your dietary team is well versed in the sanitation, cross contamination, and general food handling procedures. Rest assured they will be quizzed by the survey team and/or the ADPH division of Food, Milk and Lodging.
- Ask your residents what they would like to see on the menu. This will drastically improve the satisfaction of your food service program if residents are giving input into their food choices.
ovided 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 dietician. At no time shall a resident be offered less than 1,400 calories daily, unless specifically ordered by a physician. (Class I)
If your facility decides to provide special therapeutic diets, you must have a physician’s order on file for every resident who is requiring one. Keep this in the resident’s healthcare file as well as in the dietary files to ensure you are covered.
Pro Tip:
- Ensure your dietary team is well versed in sanitation, cross-contamination, and general food handling procedures. Rest assured they will be quizzed by the survey team and/or the ADPH division of Food, Milk and Lodging.
- Ask your residents what they would like to see on the menu. This will drastically improve the satisfaction of your food service program if residents are giving input into their food choices.