North Carolina Administrative Code
Title 10A - HEALTH AND HUMAN SERVICES
Chapter 06 - AGING - PROGRAMS OPERATIONS
Subchapter K - NUTRITION SERVICES
Section .0200 - SERVICE PROVISION
Section 06K .0203 - MENU PLANNING REQUIREMENTS
Universal Citation: 10A NC Admin Code 06K .0203
Current through Register Vol. 39, No. 6, September 16, 2024
(a) Agencies providing congregate nutrition or home delivered meal services must comply with the following menu planning requirements:
(1) Each meal served shall contain at least
one-third of the current daily Recommended Dietary Allowances as established by
the Food and Nutrition Board of the National Research Council of the National
Academy of Sciences. If a nutrition program provides additional meals, then the
nutrient analysis of the combined food items may be used to document that at
least two-thirds of the Recommended Dietary Allowances have been provided for
two meals per day or 100% of the Recommended Dietary Allowances for three meals
per day, rather than each individual meal providing one-third of the
nutrients.
(2) All foods must be
identified on the menu in order to calculate nutrient value.
(3) The calorie content must be at least 700
calories per meal.
(4) The sodium
content shall not exceed 1,300 mg per meal.
(5) Recipes for all foods used in combination
must be supplied to the person responsible for certifying the menu to
facilitate nutrient analysis. When recipe ingredients are changed, the recipe
must be re-submitted for approval by the licensed
dietitian/nutritionist.
(6) All
prepared or breaded meat items or meat in combination must be specified on the
menu.
(7) The form of vegetable or
fruit used (fresh, frozen, dried, or canned) must be indicated on the menu for
nutrient analysis.
(b) Menu Requirements
(1) All menus shall be
written at least 20 days in advance of the meal and shall be certified by a
licensed dietitian/nutritionist to assure the menus provide one-third of the
current Recommended Daily Allowances.
(2) All regular menus shall be submitted to
the dietitian/nutritionist for review and approval at least two weeks prior to
use.
(3) The approved menus shall
be kept on file, with any changes in writing, for at least one year by the
service provider.
(4) At least one
hot or cold nutritious meal shall be provided daily at least five days a week.
Frozen, canned, dehydrated, or nutritional supplement products may also be used
for emergency situations and additional or weekend meals. All frozen meals
shall be dated with the delivery dates.
(5) Menus with serving dates must be posted
in a conspicuous location in each congregate meal site as well as each
preparation area.
(6) All menus
shall be adhered to subject to seasonable availability of food items as well as
availability of USDA donated food.
(c) Therapeutic Diet Standards.
(1) Prior to serving a therapeutic diet, a
physician's prescription written according to the guidelines in the current
North Carolina Dietetic Association Diet Manual shall be on file with the
nutrition service provider.
(2)
Each therapeutic diet prescription shall be re-ordered in writing by the
physician every six months. Menus for each type of therapeutic diet must be
written by a qualified dietitian/nutritionist. Menus for the therapeutic diets
shall follow the standard set forth in the North Carolina Dietetic Association
Diet Manual. These menus shall remain on file for at least one year.
(d) Each food group and amount of the following "Menu Pattern" shall be offered and must be available to be served to each participant.
MENU PATTERN FOOD GROUP AMOUNT
Meat/Meat Alternative 2 ounces cooked, edible portion or equivalent
Bread/Grains 2 servings
Vegetables/Fruits 2 servings
Fats total fat not to exceed 30% of total calories per meal
Dairy 1 serving
(1) Meat/Meat Alternative Group.
(A) The total protein content of each meal
must be no less than 21 grams. Of this, 14 grams must be a "complete protein"
in the form of 2 oz. edible meat, fish or poultry, exclusive of fat, bone, or
gristle. One-half cup cooked drained dried beans, peas or lentils may be used
as a substitute for 1 oz. of meat. One cup of dried beans may be used as a
substitute for 2 oz. meat; however, a "complementary" protein source must be
served at the same meal with the one cup dried beans in order to serve a
complete protein (i.e., rice, corn, or cornbread). Other protein sources such
as one egg or two tablespoons peanut butter may also be substituted for 1 oz.
meat.
(B) Ground meat may be used
in entrees no more than twice in one week. Casseroles or other mixed dishes
must have ingredients specified on the menu to facilitate nutrient
analysis.
(2)
Bread/Grains Group. Each meal shall contain two servings of a whole grain or
enriched grain product.
(3)
Vegetable/Fruit Group.
(A) Each meal must
contain two servings of different fruits and vegetables. When salad is served,
it must be placed in a separate compartment of a compartmental tray to avoid
mixing with other foods or served in a separate salad bowl. Juice may fulfill
no more than half of the vegetable/fruit requirement for any one
meal.
(B) One serving of vitamin
C-rich food must be served twice per week. The USDA Food Values Handbook lists
all foods containing Vitamin C.
(4) Fat Group. Total fat shall not exceed 30%
of the total calories per meal. One teaspoon of butter or fortified margarine
in an individual covered package chip or container may be used if it adds
palatability to the menu. The menu must identify whether gravy, salad dressing,
mayonnaise, margarine or butter is used when served.
(5) Dairy Group. Each meal must contain a
total of no less than. 400 mg. calcium. This may be obtained by one serving of
8 ounces of whole, low fat, skim, buttermilk, chocolate (not chocolate drink),
sweet acidophilus milk, or Ultra High Temperature (UHT) milk, fortified with
vitamins A &D in an individually sealed carton, or other foods.
Authority
G.S.
143B-181.1(c);
Eff. November 1, 1993;
Amended Eff. July 1, 2003;
Pursuant to
G.S.
150B-21.3A, rule is necessary without
substantive public interest Eff. September 6,
2016.
Disclaimer: These regulations may not be the most recent version. North Carolina may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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