19 CSR 30-86.052 - Dietary Requirements for Residential Care Facilities and Assisted Living Facilities
PURPOSE: This rule establishes standards for meeting dietary needs of residents in residential care facilities I and II.
(1) Each resident shall
be served food prepared and served under safe, sanitary conditions that is
prepared consistent with the preferences of the resident and in accordance with
attending physician's orders. The nutritional needs of the residents shall be
met. Balanced nutritious meals using a variety of foods shall be served.
Consideration shall be given to the food habits, preferences, medical needs and
physical abilities of the residents. II/III
(2) Each resident shall receive and the
facility shall provide at least three (3) meals daily, at regular times
comparable to normal mealtimes in the community. At least two (2) meals daily
shall be hot. II/III
(3) There
shall be no more than fourteen (14) hours between a substantial evening meal
and breakfast the following day, except when a nourishing snack is provided at
bedtime. Up to sixteen (16) hours may elapse between a substantial evening meal
and breakfast the following day if a resident group agrees to this meal span,
and a nourishing snack is served. III
(4) Fresh water shall be available to the
resident at all times. II/III
(5)
Dining room service for residents shall be attractive and each resident shall
receive appropriate table service. III
(6) Menus shall be planned in advance and
shall be readily available for personnel involved in food purchase and
preparation. Food shall be served as planned although substitutes of equal
nutritional value and complementary to the remainder of the meal can be made if
recorded. III
(7) A three (3)-day
supply of food shall be maintained in the facility. III
(8) If a physician prescribes in writing a
modified diet for a resident, the resident may be accepted or remain in the
facility if-
(A) The physician monitors the
resident's condition on a regular periodic basis and at least quarterly;
II
(B) The diet, food preparation
and serving is reviewed at least quarterly by a consulting nutritionist,
dietitian, registered nurse or physician and there is written documentation of
the review; II/III
(C) The modified
diet menu is posted in the kitchen and includes portions to be served; III
and
(D) The facility has entered
into a written agreement for dietary consultation with a nutritionist,
dietitian registered nurse or physician. III
(9) Nothing in this rule shall be construed
as taking precedence over the resident's right to make decisions regarding his
or her eating and dining preferences.
(A) In
assisted living facilities, information about the resident's eating and dining
preferences shall be incorporated in his or her individualized service plan
based on an assessment that includes the resident's culture, life-long
routines, habits, patterns and preferences. III
(B) In assisted living facilities, if the
resident's eating and dining preferences have a potential health risk, staff
shall inform the resident or his or her legally authorized representative of
the potential health risks and document this in his or her individualized
service plan. III
Notes
All rules relating to long-term care facilities licensed by the department are followed by a Roman Numeral notation which refers to the class (either class I, II or III) of standard as designated in section 198.085.1, RSMo 1986.
*Original authority: 198.005, RSMo 2006; 198.073, RSMo 1979, amended 1984, 1992, 1999, 2006; and 198.076, RSMo 1979, amended 1984.
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