The program management must provide each participant with a nourishing, palatable, well-balanced meal that proportionally meets the daily nutritional and special dietary needs of each participant.
(a)Food and nutritional services. The program management provides and/or contracts with a food service entity and provides and/or contracts sufficient support personnel competent to carry out the functions of the food service.
(1) The program management must employ a qualified dietitian either part-time or on a contract consultant basis to provide nutritional guidance.
(2) A qualified dietitian is one who is qualified based upon registration by the Commission on Dietetic Registration of the American Dietetic Association.
(3) The dietitian must—
(i) Conduct participant nutritional assessments and recommend nutritional intervention as appropriate.
(ii) Consult and provide nutrition education to participants, family/caregivers, and program staff as needed.
(iii) Consult and provide education and training to the food service staff.
(iv) Monitor and evaluate participants receiving enteral tube feedings and parenteral line solutions, and recommend changes as appropriate.
(b)Menus and nutritional adequacy.
(1) The participant's total dietary intake is of concern but is not the adult day health care program's responsibility.
(2) The program is responsible for the meals served in the facility.
(c)Food. Each participant receives and the program provides—
(1) Food prepared by methods that conserve nutritive value, flavor, and appearance;
(2) Food that is palatable, attractive, and at the proper temperature;
(3) Food prepared in a form designed to meet individual needs; and
(4) Substitutes offered of similar nutritive value to participants who refuse food served.
(1) Therapeutic diets must be prescribed by the primary care physician.
(2) Special, modified, or therapeutic diets must be provided as necessary for participants with medical conditions or functional impairments.
(3) An adult day health care program must not admit nor continue to serve a participant whose dietary requirements cannot be accommodated by the program.
(e)Frequency of meals.
(1) At regular times comparable to normal mealtimes in the community, each participant may receive and program management must provide at least two meals daily for those veterans staying more than four hours and at least one meal for those staying less than four hours.
(2) The program management must offer snacks and fluids as appropriate to meet the participants' nutritional and fluid needs.
(f)Assistive devices. The program management must provide special eating equipment and utensils for participants who need them.
(g)Sanitary conditions. The program must—
(1) Procure food from sources approved or considered satisfactory by Federal, State, or local authorities;
(2) Store, prepare, distribute, and serve food under sanitary conditions; and