HAR §11-99-58. Dietetic services

(a) The food and nutrition needs of residents shall be met through a nourishing, well-balanced diet in accordance with the recommended dietary allowances of the Food and Nutrition Board of the National Research Council, and adjusted for age, sex, activity, and disability. The service shall be directed by a dietetic service supervisor. (b) At least three meals shall be served daily, at regular times with: §11-99-56 (1) Not more than a fourteen hour span between a substantial evening meal and breakfast on the following day. (2) Between meal nourishments consistent with need shall be offered routinely to all residents. (c) Modified or therapeutic diets shall be: (1) Prescribed by the resident's physician with a record of the diet as ordered kept on file and reviewed at least annually. (2) Planned, prepared, and served by qualified personnel. (3) Reviewed and adjusted as needed by a qualified dietitian. (d) A nutritional assessment and plan for each resident should be recorded in the medical record. The plan should be incorporated in the overall plan of care and reviewed as needed. (e) Food services, planning and storage (1) Menus (A) Shall be written at least one week in advance. (B) Shall provide a sufficient variety of foods served in adequate amounts at each meal, and adjusted for seasonal changes along with resident's preferences as much as possible. (C) Shall be different for each day of the week. If a cycle menu is used, the cycle must cover a minimum of four weeks. (D) Shall be filed and maintained with any recorded changes, for at least three months. (2) Food orders or requisitions for purchase. (A) Records for food purchased shall be filed and maintained for at least thirty days. (3) Storing and handling of food (A) All food shall be procured, stored, prepared, distributed, and served under sanitary conditions. (B) Dry or staple food items shall be stored above the floor in a ventilated room not subject to seepage or waste water §11-99-56 backflow, or contamination by condensation, leakages, rodents, or vermin. (C) Perishable foods shall be stored at the proper temperatures to conserve nutritive values and prevent spoilage. (4) Food service (A) Food shall be served in a form consistent with the needs of the residents and their ability to consume it. (B) Food shall be served with the appropriate utensils. (C) Effective procedures to promptly and consistently clean all equipment and work areas shall be enforced. (D) All personnel handling food shall be given appropriate personal hygienic instructions at regular intervals and this procedure shall be documented. (E) Handwashing facilities, including hot and cold water, soap, and paper towels adjacent to the work areas shall be provided. (F) Individuals needing special equipment, implements, or utensils to assist them when eating shall have such items provided by the facility. (G) There shall be a sufficient number of competent personnel to fulfill the food and nutrition needs of residents. (H) If the food service is directed by a person other than a qualified dietitian, there shall be frequent and regularly scheduled consultation by a dietitian or public health nutritionist. This consultation shall be given in the facility at the rate of four hours per every twenty-five residents per month and shall not be less than six hours per month. Consultation, training and inservice education shall be appropriate to staff and resident needs and shall be documented. (I) Provision may be made for food service