§ 2800.161. Nutritional adequacy.
(a) Meals shall be offered that meet the recommended dietary allowances
established by the United States Department of Agriculture.
(b) At least three nutritionally well-balanced meals shall be offered daily to
the resident. Each meal shall include an alternative food and drink item from
which the resident may choose.
(c) Additional portions of meals and beverages at mealtimes shall be available for the resident.
(d) A resident’s special dietary needs as prescribed by a physician, physician’s assistant, certified
registered nurse practitioner or dietitian shall be met.
Documentation of the resident’s special dietary needs shall be kept in the resident’s record.
(e) Dietary alternatives shall be available for a resident who has special
health needs or religious beliefs regarding dietary restrictions.
(f) Drinking water shall be available to the resident at all times.
(g) Between-meal snacks and beverages shall be available at all times for
each resident, unless medically contraindicated as documented in the resident’s
support plan.
(h) Residents have the right to purchase groceries and prepare their own food
in addition to the three meal plan required in § 2800.220(b) (relating to service
provision) in their living units unless it would be unsafe for them to do so consistent with their support plan.
Cross References

§ 2800.162. Meals.
(a) There may not be more than 15 hours between the evening meal and the
first meal of the next day. There may not be more than 6 hours between breakfast
and lunch, and between lunch and supper. This requirement does not apply if a
resident’s physician has prescribed otherwise.
(b) When a resident misses a meal, food adequate to meet daily nutritional
requirements shall be available and offered to the resident.
(c) Menus, stating the specific food being served at each meal, shall be prepared for 1 week in advance and
shall be followed. Weekly menus shall be posted
1 week in advance in a conspicuous and public place in the residence.
(d) Past menus of meals that were served, including changes, shall be kept for
at least 1 month.
(e) A change to a menu shall be posted in a conspicuous and public place in
the residence and shall be accessible to a resident in advance of the meal. Meal
substitutions shall be made in accordance with § 2800.161 (relating to nutritional
(f) A resident shall receive adequate physical assistance with eating or be
provided with appropriate adaptive devices, or both, as indicated in the resident’s
support plan.
(g) Appropriate cueing shall be used to encourage and remind residents to eat
and drink, as indicated in the resident’s support plan.
Cross References
This section cited in 55 Pa. Code § 2800.220 (relating to service provision).

§ 2800.163. Personal hygiene for food service workers.
(a) Staff persons, volunteers and residents involved in the storage, preparation, serving,
and distributing of food shall wash their hands with hot water and
soap prior to working in the kitchen areas and after using the bathroom.
(b) Staff persons, volunteers and residents shall follow sanitary practices
while working in the kitchen areas.
(c) Staff persons, volunteers and residents involved with the storage, preparation, serving
and distributing of food shall be in good health.
(d) Staff persons, volunteers and residents who have a discharging or infected
wound, sore, lesion on hands, arms or any exposed portion of their body may not
work in the kitchen areas in any capacity.

§ 2800.164. Withholding or forcing of food prohibited.
(a) A residence may not withhold meals, beverages, snacks or desserts as
punishment. Food and beverages may be withheld in accordance with prescribed
medical or dental procedures.
(b) A resident may not be forced to eat food.
(c) If a resident refuses to eat or drink continuously during a 24-hour period,
the resident’s primary care physician and the resident’s designated person shall
be immediately notified.
(d) If a resident has a cognitive impairment that affects the resident’s ability
to consume adequate amounts of food and water, a staff person shall encourage
and remind the resident to eat and drink.