Majority of nursing homes in US have been functioning using the 3R’s—Rules, Routines and Requirement—even 20 years after the passage of the 1987 Nursing Home Reform Act, which stated that the people residing in nursing homes are entitled to a home where they can reside for the result of their lives as individuals. The focus has been changing slowly from the tasks to the care of the people. A 2010 survey found that 40% of the 16,500 total long term care facilities in the US failed to meet the bases of 42 CFR Part 483, sections B relating to food service operations.
The Medicare program is administered by CMS, which is an agency of the US department of health and Human Services. States may also establish additional requirements under the Medicaid program. Typically the federal government sets minimum standards; states may develop more specific standards and those that provide the greatest degree of control will apply.
If you are a dietary manager, it is your responsibility to be very familiar with the rules and regulations established in the state under various regulatory, including the Food Service CMS guidelines, for the type of facility where you work. The dietary manager must provide a nutritionally adequate diet. The diet should supply the nutrients for the age group being served. The nursing homes in US are required to adhere to 42 CFR Part 483, sections B relating to food service operations, which includes many requirements that includes, quality of life, quality of care, nursing services and dietary services, along with many others. Anyone responsible of looking after or running a nursing home is required to follow all of those clauses and be updated with it.
Quality of Life and Dietary Services in the Facility
It is important that a facility, especially nursing homes, take care for its residents in a manner and in an environment that promotes maintenance or enhancement of each resident’s quality of life and is in accordance to the Food Service CMS guidelines. It must enhance every resident’s respect and dignity in full recognition of one’s individuality. The person residing there has the right to choose schedules, activities and health care according to his/her assessments, interests and care plan. One can interact with other members in the community and also with the ones outside the community. An individual has the right to make choices of one’s aspects of life in the facility. The environment that is provided to the resident should be comfortable, clean, safe, and homelike, allowing the resident to use his or her personal belongings to the extent possible.
One thing that almost every human being needs on a regular basis is a palatable diet. Everyone wants to be satisfied when he/she is having breakfast, lunch, dinner etc. Looking after the diet of the ones residing in nursing home is of utmost importance. In order to ensure that, the facility must make sure to employ a qualified dietitian either part-time, full-time or on a consultant basis. A qualified dietitian would be qualified based upon registration by the Commission on Dietetic Registration of the American Dietetic Association or on the basis of his/her training experience or education in identifying dietary needs, planning and implementation of dietary programs. The food prepared in the facility should meet the nutritional requirements of people residing there. It must be in following the recommended dietary allowances of the Food and Nutrition Board of the National Research Council, National Academy of Sciences. The food should be prepared by methods that conserve its nutrient value, appearance and flavor. It should be attractive, palatable and at proper temperature.
To know much more about these, attend this conference by our expert speaker Larry D. Bowe, BS, CFPMT, CFPMP, which focuses on the Food Service CMS guidelines and the ways to perform within the intended regulation by understanding and interpreting the intent.
