Food and Dining Service

Food and Dining Service 

Effective Date: [Original NPP Date] 
Revised Date: [Current Date] 

Objective: 

The objective of food service is to supply the resident with a diet that meets their nutritional needs. 

Policy: 

Responsibility: 

• The responsibility of determining the resident's needs rests with the resident's physician, the nurse in charge, and the dietitian. The type of diet is prescribed by the physician. 

• Cycle menus are prepared by the dietitian for all diets and reviewed with the Director of Nurses for approval. 

Meal Service: 

• Three meals are served daily: 

• Breakfast: __________ 

• Lunch: __________ 

• Supper: __________ 

• There shall be no more than 14 hours between the evening meal and breakfast, and no less than ten hours between breakfast and the evening meal. 

Nourishments: 

• A nourishment will be supplied to residents between meals in the afternoon and evening. Additionally, a mid-morning nourishment will be provided to specific residents who require them. 

• Nourishments will consist of a liquid (such as milk or juice) and a snack (such as cookies or crackers). 

• Nursing Assistants will pass the nourishments and assist residents needing assistance, following the nourishment listed for each resident. 

• Residents are allowed solid or liquid nourishment at any time unless otherwise indicated by the physician or contraindicated by diet prescription. 

Therapeutic Diets: 

• Prepared and served as prescribed by the attending physician. 

• Planned by a qualified registered dietitian. 

• A current diet manual is readily available to the cooks and Charge Nurse. 

• Necessary substitutions are made by the dietitian and/or the Food Service Manager, documented on the appropriate form, and kept on file in the Dining Service Department. 

Feeding of Residents: 

• Trays will be delivered from the kitchen to each unit or dining room. 

• All residents are encouraged to feed themselves. Self-help feeding devices are available to promote residents' independence in eating, as assessed by the nurse. 

• Residents requiring help in eating are assisted promptly upon receipt of meals. 

• If a resident refuses the food served, substitutes in accordance with the resident’s diet are provided. 

• Trays are picked up by nursing staff at the end of each meal and returned to the food carts or designated area. 

• Dining Services personnel will return food carts to the kitchen. 

Dining Room: 

• Table service is provided for all residents who can and will eat at the table, including wheelchair residents, to help them maintain as normal a living pattern as possible. 

• Seating arrangements are made in accordance with the wishes of the resident as far as possible. When necessary to assign places, the congeniality and social needs of the resident are considered. 

Charting: 

• A record of food and fluid intake will be kept on the proper form when ordered by the physician or deemed necessary by the Charge Nurses. Maintenance of the record will be the responsibility of the Charge Nurse. 

• Any nutritional problems are reported to the nurse in charge, Food Service Manager, dietitian, and physician when necessary, and noted in the nurse's notes. 

• The resident’s appetite at each meal will be recorded on the nursing flow sheet. 

Transmission of Diet Orders and Resident Requests: 

• Each resident’s diet is reviewed monthly by the attending physician in Skilled Nursing Facility (SNF) and every 60 days in Intermediate Care Facility (ICF). Should a change be indicated, the nurse is responsible for making out a change in diet form and forwarding it to the Dietitian or Food Service Manager. 

• When a resident expresses likes and dislikes, the nurse completes a change in dietary needs form indicating the resident’s preferences and forwards it to the Dining Services Department. These preferences are recorded in the nutritional care kardex. 

• Each resident is seen by the dietitian to review their diet on admission, as necessary, and at least four times a year. 

• Requests to review diets can be made by the physician, family, nurse, or resident, and communication is handled by the nurse to the Dining Service Department. 

• All of the above is documented in the Nutrition Progress Notes. 

References: 

• Centers for Medicare & Medicaid Services. State Operations Manual, Appendix PP - Guidance to Surveyors for Long Term Care Facilities. [Link to current CMS SOM] 

• CMS Requirements of Participation for Long-Term Care Facilities. [Link to current guidelines] 

• Connecticut Department of Public Health. [Link to Connecticut DPH guidelines]