26 Tex. Admin. Code § 554.1107 - Menus, Nutritional Adequacy, and Meal Service
(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.
Notes
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