Ariz. Admin. Code § R9-10-2223 - Food Services

A. An administrator shall ensure that a registered nurse who is part of the interdisciplinary team for a resident requiring a modified or special diet:

1. Consults with a registered dietitian or the resident's designated medical practitioner, as needed, about the resident's modified or special diet;

2. Reviews a food menu before the food menu is used to ensure that the resident's nutritional needs are being met;

3. Documents the review of a food menu; and

4. Is available for consultation regarding the resident's nutritional needs.

B. An administrator shall ensure that:

1. Food is prepared:

a. Using methods that conserve nutritional value, flavor, and appearance;

b. Taking into consideration the food allergies and preferences of the residents;

c. Including for a resident the modified or special diet for the resident; and

d. In a form to meet the needs of a resident, such as cut, chopped, ground, pureed, or thickened;

2. A food menu:

a. Is prepared at least one week in advance,

b. Includes the foods to be served on each day,

c. Is conspicuously posted at least one day before the first meal on the food menu will be served,

d. Includes any food substitution no later than the morning of the day of meal service with a food substitution, and

e. Is maintained for at least 60 calendar days after the last day included in the food menu;

3. Meals and snacks for each day are planned and served using the applicable guidelines in http://www.health.gov/dietaryguide-lines/2015.asp;

4. A resident is provided:

a. A diet that meets the resident's nutritional needs as specified in the resident's comprehensive assessment and individual program plan;

b. Food served in sufficient quantities to meet the resident's nutritional needs and at an appropriate temperature;

c. Three meals a day with not more than 14 hours between the evening meal and breakfast; and

d. The opportunity to have additional food between meals, unless a restrictive diet is specified in the resident's individual program plan;

5. A resident is provided with food substitutions of similar nutritional value if:

a. The resident refuses to eat the food served, or

b. The resident requests a substitution;

6. Recommendations and preferences are requested from a resident or the resident's representative for meal planning;

7. If food is used as a part of a program to manage a resident's inappropriate behavior:

a. A special diet is included as part of the resident's individual program plan, and

b. The special diet is reviewed and evaluated by a physician and a dietitian to ensure the special diet meets the resident's nutritional needs;

8. Meals are served to residents at tables in a dining area and in a manner that allows the resident to eat from an upright position, unless otherwise specified in the resident's individual program plan or by the resident's designated medical practitioner;

9. A resident requiring assistance to eat is provided with assistance that recognizes the resident's nutritional, physical, and social needs, including the use of adaptive eating equipment or utensils;

10. Personnel members supervise meals in dining areas to:

a. Direct a resident's self-help dining procedures,

b. Ensure a resident consumes enough food to meet the resident's nutritional needs, and

c. Ensure that a resident eats in a manner consistent with the resident's developmental level;

11. Tableware, utensils, equipment, and food-contact surfaces are clean and in good repair; and

12. Water is available and accessible to residents.

Notes

Ariz. Admin. Code § R9-10-2223

New Section made by final exempt rulemaking at 28 A.A.R. 927, effective 4/15/2022.