New Hampshire Code of Administrative Rules
He - Department of Health and Human Services
Subtitle He-P - Former Division of Public Health Services
Chapter He-P 800 - RESIDENTIAL CARE AND HEALTH FACILITY RULES
Part He-P 803 - NEW HAMPSHIRE NURSING HOME RULES
Section He-P 803.20 - Food Services

Universal Citation: NH Admin Rules He-P 803.20

Current through Register No. 40, October 3, 2024

(a) The licensee shall provide food services that:

(1) Meet the U.S. Department of Agriculture recommended dietary allowance as specified in the United States Department of Agriculture's "Dietary Guidelines for Americans 2015-2020" (Eighth Edition), available as noted in Appendix A;

(2) Provide the nutritional needs of each resident;

(3) Meet the special dietary needs associated with health or medical conditions for each resident as identified by the health examination required by He-P 803.15(h) ;

(4) Include provision of a food service manager who shall;
a. Be responsible for the day to day operation of the kitchen;

b. Have knowledge of the nutritional requirements for residents and of the planning and preparation of prescribed diets; and

c. Have all the required competencies as per the licensee's policy;

(5) Include facilities and equipment for meal delivery and assisted feeding, as applicable; and

(6) Include dining facilities that have eating areas sufficient in size to provide seating for at least 50% of the licensed capacity.

(b) Each resident shall be offered at least 3 meals in each 24-hour period when the resident is in the licensed premises unless contraindicated by the resident's care plan.

(c) Snacks shall be available and offered between meals and at bedtime if not contraindicated by the resident's care plan.

(d) If a resident refuses the item(s) on the menu, a substitute shall be offered.

(e) Menus, including beverages for regular and therapeutic diets, shall be planned and written for at least 2 weeks in advance of serving.

(f) Each day's menu shall be posted in a place accessible to food service personnel and residents.

(g) A listing of the diet orders and allowed foods for each resident shall be available to personnel.

(h) A dated record of menus as served shall be maintained for at least 3 months.

(i) The licensee shall provide therapeutic diets to residents only as directed by a licensed practitioner or other professional with prescriptive authority.

(j) Residents requiring therapeutic diets shall have an assessment of nutritional status by a qualified dietitian or dietary technician at least quarterly and with any significant weight loss or weight gain.

(k) If a resident has a pattern of refusing to follow a prescribed diet, personnel shall document the reason for the refusal in the resident's medical record along with education relating to non-compliance with prescribed diet, and notify the resident's licensed practitioner.

(l) For the purposes of emergency preparedness, each licensee shall have the following supplies of foods maintained on the premises for the average daily census and staff:

(1) Enough refrigerated, perishable foods for a 3-day period;

(2) Enough non-perishable foods for a 7-day period; and

(3) Enough drinking water for a 3-day period.

(m) All food and drink provided to the residents shall be:

(1) Safe for human consumption and free of spoilage or other contamination;

(2) Stored, prepared and served in a manner consistent with safe food handling practices for the prevention of food borne illnesses, including those set forth in He-P 2300;

(3) Served at the proper temperatures;

(4) Labeled, dated and stored at proper temperatures; and

(5) Stored so as to protect it from dust, insects, rodents, overhead leakage, unnecessary handling, and all other sources of contamination.

(n) The use of outdated, unlabeled food or canned goods that have damage to their hermetic seal shall be prohibited and such goods shall be immediately discarded or distinctly segregated from the usable food.

(o) All food not in the original package shall be stored in labeled and dated containers designed for food storage.

(p) All work surfaces shall be cleaned and sanitized after each use.

(q) All dishes, utensils and glassware shall be in good repair, cleaned, and sanitized after each use and properly stored.

(r) All food service equipment shall be kept clean and maintained according to manufacturer's guidelines.

(s) If soiled linen is transported through food service areas, the linen shall be in an impervious container.

(t) Garbage or trash in the kitchen area shall be placed in lined containers with covers.

(u) All nursing home personnel involved in the preparing and serving of food shall wash their hands and exposed portions of their arms with liquid soap and running water before handling or serving food.

(v) Regularly scheduled training programs including sanitation and safety shall be made available to personnel. Information as to the content and length of this training shall be documented and kept in employee records.

#9856-A, eff 1-26-11

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