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Regulations > Dietary Services > Flashcards

Dietary Services Flashcards

1
Q

What must food be like at a SNF?

A 
-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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2
Q

How must a facility hire a qualified dietitian?

A

-Both-483.35/19.1101

Either on a full time or consultation basis.

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3
Q

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

A

-Texas only-19.1102

One Year

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4
Q

The Director of food services MUST be:

A

-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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5
Q

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

A

-Both-483.35/19.1102-2&3

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

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6
Q

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

A

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

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7
Q

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

A

-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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8
Q

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

A

-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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9
Q

How far in advanced must a menu be prepared?

A

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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10
Q

Who must write the menu?

A

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

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11
Q

How often must the menu change?

A

-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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12
Q

If the menu is not FOLLOWED what must happen?

A

-Texas Only-19.1107-a-&d-

Substitutions are allowed but must be documented.

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13
Q

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

A

-Texas Only-19.1107-d-
30 days

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

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14
Q

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

A

-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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15
Q

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

A

-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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16
Q

Where must the menu for the WEEK be posted?

A

-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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17
Q

Posted menu must be for what length of time?

A

-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?

18
Q

How old can the diet manual be?

A

-Texas Only-19.1107

No older than 5 years

19
Q

How much food must be on hand at all times?

A

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

20
Q

If a menu item is substituted what must be happen?

A

-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

21
Q

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

A

-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)

22
Q

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

A

-Texas Only-19.1107-h

An ID system must be made. (Tray Cards)

23
Q

Therapeutic diets must be prescribed by who?

A

-Fed Only-483.35-e-

The attending physician

24
Q

Food must be?

A 
-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-
25
Q

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

A

–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.

26
Q

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

A

-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.

27
Q

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

A

–Both-483.35/19.1110-

3 times a DAY & must be served at regular times compared to the community

28
Q

How much time can there be between Dinner and Breakfast?

A

–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

29
Q

When must SNACKS be provided?

A

–Both-483.35/19.1110

Snacks must be provided at BEDTIME. Snacks through out the day are NOT required.

30
Q

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?

A

-Texas Only-19.1111

No, No, No

31
Q

Where can paid feeding assistants feed residents?

A

Only in the dinning room -Texas- 19.1113

Anywhere but must call for help using resident call system-Fed-483.35-h-

32
Q

Can a paid feeding assistant feed anyone?

A

-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)

33
Q

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

A

-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.

34
Q

Where can a facility obtain there food?

A

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.

35
Q

How is garbage to be transported and stored?

A

F372
Must be Transported and STORED with a LID!

***Also Trash cans and Containers/Bins must be kept in good order. NO LEAKS

36
Q

Significant Weight loss is:

A

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

37
Q

How many drinks PER meal is required?

A

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

38
Q

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

A

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

39
Q

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

A

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.

40
Q

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

A

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

41
Q

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

A

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

Regulations (17 decks)

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