What better week to talk about menus to meet resident needs than the week where we are ready to cook for hours and feast with family and friends – Thanksgiving week! This week’s Ftag of the Week is F803 Menus Meet Resident Needs/ Prepared in Advance/ Followed, which is the current F363. Just like those picky eaters that we all have visiting for the holidays, we need to consider the needs and preferences of the residents considerably more under the new RoPs.
F803 includes the current F363 requirements for having menus that meet the nutritional needs of residents (in accordance with established national guidelines), that are prepared in advance and are followed, but there are some new additions to the regulation that need to be considered. These include:
- Menus are updated periodically
- Menus are reviewed by the facility’s dietitian or other clinically qualified nutrition professional for nutritional adequacy
- That none of the requirements of this regulation should be construed as limiting a resident’s rights to make personal dietary choices
- Reflect, based on a facility’s reasonable efforts to meet, the religious, cultural and ethnic needs of the resident population, as well as input received from residents and resident groups, while using established nutritional guidelines
This last bullet is the true intent of F803, to make sure that resident choices, whether they are nutritional, religious, cultural or ethnic, are taken into consideration by the facility. This means, that each resident’s needs and preferences have been assessed and that the facility is able to demonstrate that it has taken actions to meet those needs and preferences. The IG states that these actions can be identifying preparation methods/approaches, determining whether the purchase of specific food items can occur and if there are available procurement sources for the food items, as well as if the facility is able to serve the food. As always, remember that menus need to be nutritionally adequate.
Does this mean that there needs to be an individualized menu for every resident? No, but just like a good host makes sure that there’s something everyone will eat, including the vegan that we will have at our Thanksgiving table this year, CMS expects that there will be alternative menus that are “aligned with individual needs and preferences” that should be available if the primary menu/ immediate selections for a meal are not appealing to the resident. Facilities are expected to make “reasonable and good faith efforts” to develop menus that are based on resident groups’ feedback and resident requests. This emphasizes person-centered care and ensuring residents retain their autonomy.
Happy Thanksgiving from the CMSCG team. Missed any of our “Ftag of the Week” series? You can view all the Ftags we’ve covered on the CMSCG Blog here. November 28th is only 1 week away!