Current through Register Vol. 46, No. 39, September 25, 2024
The facility shall provide each resident with a
nourishing, palatable well-balanced diet that meets the daily nutritional and
special dietary needs of each resident.
(a) Direction. The facility shall employ a
qualified dietitian either full-time, part-time or on a consultant basis who
shall be responsible for the nutrition services in the nursing home.
(1) The facility shall designate a qualified
dietitian or a dietetic service supervisor qualified on the basis of education,
training and experience in food service management to serve as the director of
food service. If the director of food service is not a qualified dietitian,
such individual shall receive frequently scheduled consultation from a
qualified dietitian.
(2) A
qualified dietitian is one who is qualified based upon:
(i) registration by the Commission on
Dietetic Registration of the American Dietetic Association;
(ii) education, training, and experience in
identification of dietary needs, planning and implementation of dietary
programs; or
(iii) certification as
a certified dietitian or certified nutritionist in accordance with article 157
of the Education Law.
(b) Sufficient staff. The facility shall
employ sufficient professional and support personnel competent to carry out the
functions of the dietary service.
(1) The
availability of qualified dietitian services shall be related to the number of
beds in the nursing homes, the amount and type of dietary supervision required,
and the complexity of resident needs and additional full- or part-time
qualified dietitians shall be utilized commensurate with such factors. Each
resident's nutritional care shall be under the direction of a qualified
dietitian.
(2) The facility shall
utilize one or more dietetic service supervisor(s) with consultation by a
qualified dietitian to manage the food service in the absence of the qualified
dietitian.
(c) Menus and
nutritional adequacy.
(1) Menus shall meet
the nutritional needs of residents in accordance with dietary allowances that
meet generally recognized standards of care and shall take into account the
cultural background and food habits of residents.
(i) The facility shall have an effective
means of recording and transmitting to the food service diet orders and
changes; and
(ii) The facility
shall maintain a current list of residents identified by name, location and
diet order and such identification shall accompany each resident' s meal when
it is served.
(2) Menus
shall be prepared in advance in accordance with a diet manual acceptable to the
medical, nursing and dietary services and retained for one year from the date
of serving.
(3) Menus shall be
followed.
(d) Food. Each
resident shall receive and the facility shall provide:
(1) food prepared by methods that conserve
nutritive value, flavor and appearances;
(2) food that is palatable, attractive, and
at the proper temperature;
(3) food
prepared in a form designed to meet individual needs; and
(4) substitutes offered of similar nutritive
value to residents who refuse food served.
(e) Therapeutic diets. Therapeutic diets
shall be prescribed by the attending physician, when indicated, based on the
findings of the comprehensive resident assessment.
(f) Frequency of meals.
(1) Each resident shall receive and the
facility shall provide at least three substantial meals daily, at regular times
comparable to normal mealtimes in the community.
(2) There shall be no more than 14 hours
between a substantial evening meal and breakfast the following day, except as
provided in paragraph (4) of this subdivision.
(3) The facility shall offer snacks at
bedtime daily.
(4) If a nourishing
snack as determined by a qualified dietitian in accordance with generally
accepted standards of care, is provided at bedtime, up to 16 hours may elapse
between a substantial evening meal and breakfast the following day provided
that a resident group agrees to this meal span and a nourishing snack is
served.
(g) Assistive
devices. The facility shall provide assistance with eating and special eating
equipment and utensils for residents who need them.
(h) Sanitary conditions. The facility shall
store, prepare, distribute and serve food under sanitary conditions; and in
accordance with the sanitary requirements of Part 14 (Service Food
Establishments) of Chapter I (State Sanitary Code) of this Title.
(i) Kosher food. The facility shall provide,
as part of the basic services, kosher food or food products prepared in
accordance with the Hebrew Orthodox religious requirements when the resident,
as a matter of religious belief, desires to observe Jewish dietary laws; and
shall:
(1) establish a plan and procedure for
obtaining, preparing and serving kosher foods and food products in accordance
with Hebrew Orthodox religious requirements;
(2) incorporate the provision of kosher food
and food products prepared in accordance with Hebrew Orthodox religious
requirements into the resident's comprehensive care plan; and
(3) assure that employees who are involved
with such plan of care are trained in the procedures that satisfy Hebrew
Orthodox dietary requirements.