| (a) Menus must:
(1) meet the nutritional needs of residents in accordance
with established national guidelines;
(2) be prepared at least one week in advance;
(3) be written for each type of diet ordered in the
facility, in accordance with the facility's diet manual;
(4) be written or completely evaluated for nutritional
adequacy by the facility's qualified dietitian;
(5) vary from week to week, taking the general age-group
of residents into consideration;
(6) be followed unless substitutions are documented
as required in subsection (d) of this section;
(7) reflect, based on a facility's reasonable effort,
the religious, cultural, and ethnic needs of the resident population,
as well as input received from residents and resident groups; and
(8) be updated periodically.
(b) A qualified dietitian may accept diet orders and
changes from the physician.
(c) The facility must ensure that a current diet manual,
approved by the qualified dietitian, is readily available to dietary
service personnel and the supervisor of nursing service. To be current,
the diet manual must be no more than five years old.
(d) The facility must retain records of menus served,
including substitutions, and food purchased for 30 days. A list of
residents receiving special diets and a record of their diets must
be kept in the dietary area for at least 30 days.
(e) The facility must post the current week's menu:
(1) in the dietary department, including therapeutic
diet menus, so employees responsible for purchasing, preparing, and
serving foods can use it; and
(2) in a convenient location so the residents may see
it.
(f) The dietary department must keep a seven-day supply
of staple foods and a two-day supply of perishable foods at all times.
The facility is allowed the flexibility to use food on hand to make
substitutions at any interval as long as comparable nutritional value
is maintained. Any substitution of menu items must be recorded on
the day of use.
(g) Accommodation of a resident's needs. The facility
must provide:
(1) table service for all who can and will eat at the
table, including a resident who uses a wheelchair;
(2) firm supports, such as over-bed tables, for serving
trays to a resident who is bedfast;
(3) sturdy tray stands of proper height to a resident
able to be out of bed for the resident's meals;
(4) special eating equipment and utensils for a resident
who needs them and appropriate assistance to ensure that the resident
can use the assistive devices when consuming meals and snacks; and
(5) prompt assistance for a resident who needs help
eating.
(h) An identification system, such as tray cards, must
be available to ensure that all diets are served in accordance with
physician's orders.
(i) Nothing in this section limits a resident's right
to make personal dietary choices.
|
| Source Note: The provisions of this §554.1107 adopted to be effective May 1, 1995, 20 TexReg 2393; amended to be effective March 24, 2020, 45 TexReg 2025; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871 |
