Dietary Services Flashcards by Jason Vaughan

What must food be like at a SNF?

-Both-483.35/19.1101
1-Nourishing
2-Palatable
3-Well-Balanced
4-Attractive-(483.35-c-2)(19.1108)
5-Proper Temperature-(483.35-c-2)(19.1108)

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How must a facility hire a qualified dietitian?

-Both-483.35/19.1101

Either on a full time or consultation basis.

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If a Dietitian that is licensed by the Texas State Board of Examiners of Dietitians. It is required to have ____ year of supervisory experience in dietetic service of a health care facility, before working in a NURSEING HOME

-Texas only-19.1102

One Year

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The Director of food services MUST be:

-Texas only-19.1102
(A) a qualified dietitian; OR
(B) Must have an associate-in-arts graduate in nutrition and food management OR
(C) a graduate of a dietetic technician or dietetic assistant training program approved by the American Dietetic Association OR
(D) a person who has completed a state-agency-approved 90-hour course in food service supervision; OR
(E) a person who has training and experience in food service supervision and management in a military service

*** ALL credentials MUST be evaluated and approved by a nutrition program specialist of the Texas Department of Human Services’ Long Term Care-Regulatory.

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If the Director of FOOD SERVICES is not a Dietitian then the facility is required to do what?

-Both-483.35/19.1102-2&3

The director of food services must receive consultation by a dietitian.

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The director of food Services must participate in the care plan in addition to also meeting with who?

-Texas Only-19.1102-3
1-The administrator AND
2-RN who has responsibility for residents Care plan.

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What are the minimum dietary consultant hours if the has 60 residents or Under?

-Texas Only-19.1104
Required to give 8 hours of consultation work

- for every other fraction of 30 residents an additional 4 hours
- SO if 61 residents 8+4 = 12 hours of consultation

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What is the minimum dietary consultant hours if a resident population is 61? 90? 91?

-Texas Only-19.1104
12 / 12 / 16 hours respectively

**Required to give 8 hours of consultation work + 4 hours for every other fraction of 30 residents.

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How far in advanced must a menu be prepared?

At least ONE week in advanced & followed - 19.1107

No time limit for Federal Requirement , as long as menu is prepared in advanced and followed. - 483.35-c-2

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Who must write the menu?

-Texas Only-19.1107-a-4-
The dietitian (contract or employee) OR
the prepared menu MUST be evaluated by dietitian.

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How often must the menu change?

-Texas Only-19.1107-a-5-

The menu must be different Week to Week. (can not have the same menu on back to back weeks)

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If the menu is not FOLLOWED what must happen?

-Texas Only-19.1107-a-&d-

Substitutions are allowed but must be documented.

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How long must the facility maintain a log of menus served?

-Texas Only-19.1107-d-
30 days

** All Records for Dietary are 30 days accept for DIET MANUEL – 5 years

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How long must the facility maintain a log of food purchased? and where must this log be located?

-Texas Only-19.1107-d-
30 days / and in the dietary area
** All Records for Dietary are 30 days accept for DIET MANUEL – 5 years

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How long must the facility maintain a log of special diets IE (mechanically soft)? and where must this log be located?

-Texas Only-19.1107-d-
30 days / and in the dietary area
** All Records for Dietary are 30 days accept for DIET MANUEL – 5 years

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Where must the menu for the WEEK be posted?

-Texas Only-19.1107-
1-In dietary dept. // Including therapeutic diet menus
2-IN a location where residents can SEE it.

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Posted menu must be for what length of time?

-Texas Only-19.1107
Menu must be for the week.

You must post what will be served for the week. (minimum) *** is DAILY more strict?

How old can the diet manual be?

-Texas Only-19.1107

No older than 5 years

How much food must be on hand at all times?

-Texas Only-19.1107 & 19.318-k
7 Day non-perishable
2 Day perishable

If a menu item is substituted what must be happen?

-Texas Only-19.1107
1-Food must be of comparable nutritional value
2-Food must be recorded in the LOG on the DAY of use.
3-Substitutions must be documented and approved by the dietitian. NAB p.35

What type of facility services and equipment must be provided at meal time?

-Texas Only-19.1107-f
1-Table Service (for those who want to eat at the table)
2- -Over bed tables (for bedfast residents)
3-Stand of proper height (for bed residents)
4-Special eating utensils - Both- 19.1107-f & 483.35-g-
5-Prompt!! assistance ( for residents who need help eating)

When food is served how can the facility ensure that the right resident gets the right tray?

-Texas Only-19.1107-h

An ID system must be made. (Tray Cards)

Therapeutic diets must be prescribed by who?

-Fed Only-483.35-e-

The attending physician

Food must be?

-Both-483.35/19.1108
1-Atractive
2-Palatable
3-Served at the proper TEMP
4-Correct Form ( pure/Mech Soft)
5-Able to be substituted
6-Served on TIME - Texas only- 19.1108-5-

When must snacks and In-between meals be documented in the clinical record?

--Both-483.35/19.1109 ** Also see 19.1911-13-b | When it is part of the care plan, OR as ORDERD by a physician.

When it comes food intake, what must be documented in the CLINICAL record?

-Texas Only 19.1110- 1-Food Intake 2-Deviations of Normal diet 3-Rejections of food, including substitutions 4-Snacks and supplemental feedings **ONLY when ordered by Doctor or in care plan.

How many meals must be provided daily? When are these meals served?

--Both-483.35/19.1110- | 3 times a DAY & must be served at regular times compared to the community

How much time can there be between Dinner and Breakfast?

--Both-483.35/19.1110 Not more than 14 hours, UNLESS: 1-Resident group agrees can be longer , AND 2- there is a nourishing snack at bed time * then UP to 16 hours

When must SNACKS be provided?

--Both-483.35/19.1110 | Snacks must be provided at BEDTIME. Snacks through out the day are NOT required.

If someone in dietary has a communicable disease is it ok for that person to work in the dietary department? What about an open wound? What about an infected wound?

-Texas Only-19.1111 | No, No, No

Where can paid feeding assistants feed residents?

Only in the dinning room -Texas- 19.1113 | Anywhere but must call for help using resident call system-Fed-483.35-h-

Can a paid feeding assistant feed anyone?

-Both-483.35-19.1113- NO, can not feed those who have complicated feeding problems (such as: difficulty swallowing, recurrent lung aspirations, and tube or parenteral/IV feedings)

What must the facility do record wise, to hire paid feeding assistants?

-Texas Only-19.1115 1-Must document that all persons who have taken and passed the 16 hour state course 2-Date 3-Location 4-Name of Trainer 5-Statement that was completed successfully.

Where can a facility obtain there food?

Apx.PP F-371 sources approved or considered satisfactory by Federal, State or local authorities; ** Food Vendor must be Approved, you can just go down to COSTCO and serve residents FOOD. ** However, anyone who brings in OUTSIDE food can give to RESIDENTS, it just can not be prepared BY the KITCHEN, or STAFF.

How is garbage to be transported and stored?

F372 Must be Transported and STORED with a LID! ***Also Trash cans and Containers/Bins must be kept in good order. NO LEAKS

Significant Weight loss is:

NAB Prep. P.39 5% in 30 days (1 month) 7.5% in 90 days (3 months) 10% in 180 days (6 months)

How many drinks PER meal is required?

NAB Prep. P.39 2 Beverages per meal at least 1500 CC (6 cups) per day [APX: 250 cc per beverage]

In Dietary services there should be an emergency menu how many days should this emergency menu before? and where should it be stored?

NAB Prep. P.41 3 day emergency menu should be written and kept in the KITCHEN.

Why is water intake and hydration need to be emphasized among the elderly population?

NAB p.35 Because the aging process causes a decrease in the ability no notice "thirst", so we need to always encourage them to drink.

If all food are refused at meal time what is required of the nursing staff? What is the resident finishes the meal 100 %?

1-Must offer the resident a nutrition supplement to give the resident the necessary calories. 2-Must ask if they want more?

What are the recommended daily food allowances: Meat Fruit/veggies Grain/bread

Meat- 4 oz Fruit/Veggies - 2 cups Grain/bread - 4 servings