Section 380.650  Dietetic Services


a)         The facility shall arrange for each consumer to have available at least three meals per day.  Meals shall be brought in and served separately in the triage center and crisis stabilization unit.  Not more than 14 hours shall elapse between the last and first meal.


b)         Consumer food preferences, including religious practices, shall be adhered to as much as possible and shall be from appropriate food groups.


c)         Between-meal options shall be provided as requested or required by a diet order.


d)         The dietetic services programs shall be creatively focused on encouraging or maintaining as much consumer responsibility, participation and independence as possible in choice, preparation, purchasing and cleanup with regard to food service.  This may involve formal training programs, collaborative food preparation and cleanup, family-style meal preparation with involvement of consumers, or cafeteria or buffet-style service.  Consumers with a communicable disease shall be evaluated by a registered nurse or physician prior to being allowed to assist in food preparation.


e)         With the exception of the triage centers and crisis stabilization units, the consumer's discharge and transition plan shall address his or her menu planning and food preparation level of knowledge and responsibility.


f)         Within the context of consumer food preparation training and choice, the total daily diet for consumers shall be of the quality and in the quantity to meet the nutritional needs of the consumers and be guided by the Food and Nutrition Board of the National Research Council of the National Academy of Science's standard, Recommended Dietary Allowances, adjusted to the age, activity and environment of the group involved.  All food shall be of good quality and be selected, stored, prepared and served in a safe and healthful manner.


g)         In planning menus for the facility population, which includes consumers at risk for certain chronic health conditions (e.g., diabetes and hypertension), the food and beverage options provided in prepared meals, snacks and vending machines shall include healthy choices to address these risks and conditions.  The facility shall obtain consumer feedback on the desirability of the available healthy options at least twice per year and incorporate the results in planning menu and vending options.


h)         A dietetic service supervisor shall manage and operate the food service in each facility. If the dietetic service supervisor is not a dietitian, the dietetic service supervisor shall have frequent and regularly scheduled consultation from a dietitian.


i)          Sufficient staff shall be employed, oriented and trained, and their working hours scheduled, to provide for the nutritional needs of the consumers and to maintain the dietetic service areas.  The facility shall consider having facility consumers receive food service training and employment in the facility dietary services.


j)          Under supervision, only consumers who have been screened for communicable diseases pursuant to subsection (d) may assist in cooking and kitchen activities as part of their skills training program.


k)         Dietetic service personnel, including consumers regularly participating in food service, shall be trained in basic food sanitation techniques, shall wear clean clothing, a cap or a hair net, and gloves, and shall be excluded from duty when affected by skin infection or communicable diseases.