Meals, Drinks and Snacks
17.1 The assisted living residence shall provide at least three meals daily, at regular times comparable
to normal mealtimes in the community or in accordance with resident needs, preferences, and
plans of care.
(A) Nourishing meal substitutes and between-meal snacks shall be provided, in accordance
with plans of care, to residents who want to eat at non-traditional times or outside of
scheduled meal service times.
17.2 Meals shall include a variety of foods, be nutritionally balanced and sufficient in amount to satisfy
resident appetites.
(A) Appealing substitutes of similar nutritive value shall be available for residents who choose
not to eat food that is initially served or who request an alternative meal.
17.3 The assisted living residence shall offer drinks, including water and other liquids to residents with
every meal and between meals throughout the day. The assisted living residence shall also
ensure that residents have independent access to drinks at all times.
17.4 Assisted living residence staff shall observe resident food consumption on a regular basis in order
to detect unplanned changes such as weight gain, weight loss or dehydration. Changes in
consumption that may indicate the need for assistance with eating shall be reported to the
resident’s practitioner and case manager, if applicable.
17.5 If a resident repeatedly chooses not to follow the dietary recommendations of his or her
practitioner, the assisted living residence shall document such in the record or care plan and
notify the resident’s practitioner and case manager, if applicable.
Menus
17.6 Menus shall vary daily and incorporate seasonal and/or holiday foods.
17.7 Weekly menus shall be readily available for residents and public viewing no less than 24 hours
prior to serving.
17.8 Residents shall be encouraged to participate in planning menus and the assisted living residence
shall make reasonable efforts to accommodate resident suggestions.
Food Supply
17.9 Each assisted living residence shall have sufficient food on hand to prepare three nutritionally
balanced meals per day for three calendar days.
Therapeutic Diets
17.10 An assisted living residence may provide therapeutic diets when the following conditions are met:
(A) The diet is prescribed by the resident’s practitioner, and
(B) The assisted living residence has trained staff to prepare the food in accordance with the
diet and ensure it is being served to the appropriate resident.
Assistance with Dining and Feeding
17.11 If a resident demonstrates difficulty opening, reaching or accessing food and beverage items at
meal time, staff shall promptly assist that resident in doing so regardless of the resident’s dining
location.
17.12 Staff may assist residents by cueing and prompting them to eat and drink so long as that
assistance is not undertaken for the convenience of staff.
17.13 Staff may assist feeding a resident only if the resident is able to maintain an upright position and
chew and swallow without difficulty.
17.14 Staff who assist feeding a resident shall be trained in the proper techniques for supporting
nutrition and hydration by a licensed or registered professional qualified by education and training
to assess choking risks, such as a registered nurse, speech language pathologist or registered
dietitian.
(A) The assisted living residence shall not allow staff to assist feeding a resident if the
resident has difficulty chewing and swallowing or has a history of chronic choking or
coughing while eating or drinking.
(B) If a resident who is receiving feeding assistance experiences a change in eating and
swallowing that is a decline from baseline as identified in the individualized resident care
plan, staff shall stop providing assistance, document the issue in the resident’s record
and ensure that the resident’s practitioner is notified.
(1) Unless temporary measures are ordered by the practitioner, feeding assistance
shall not be resumed until a medical evaluation has been performed and the
assisted living residence has documentation from the practitioner that it is safe to
resume.
Dining Area and Equipment
17.15 Each assisted living residence shall have a designated dining area with tables and chairs that all
residents are able to access and that is sufficient in size to comfortably accommodate all
residents. Residents shall be given the opportunity to choose where and with whom to sit.
17.16 No resident or group of residents shall be excluded from the designated dining area during meal
time unless otherwise indicated in the resident’s individualized care plan.
17.17 Meals shall not be routinely served in resident rooms unless otherwise indicated in the resident’s
individualized care plan. The assisted living residence shall, however, make reasonable efforts to
accommodate residents that choose to dine somewhere other than the dining room.
17.18 The location of resident dining shall not be chosen solely for staff convenience.
17.19 Paper or disposable plastic ware shall not be used for regular meals with the exception of
emergencies and outdoor dining