CSA CSA Dietary & Nutrition Services 1 — Questions and Answers
Question 1: Under 42 CFR §483.60, what is the minimum frequency with which a qualified dietitian must assess residents in a Medicare/Medicaid-certified nursing facility?
- Daily
- Weekly
- As needed based on care plan and significant changes (Correct answer)
- Annually only
Correct answer: As needed based on care plan and significant changes
Federal regulations require a qualified dietitian to assess residents based on their individual care plan schedule and whenever a significant nutritional change occurs.
Question 2: Which federal regulation governs food and nutrition services requirements for long-term care facilities certified by Medicare and Medicaid?
- 42 CFR §483.10
- 42 CFR §483.60 (Correct answer)
- 42 CFR §483.80
- 42 CFR §483.95
Correct answer: 42 CFR §483.60
42 CFR §483.60 contains all federal requirements for food and nutrition services in Medicare/Medicaid-certified nursing facilities.
Question 3: A nursing facility must provide menus that meet the nutritional needs of residents based on which recognized standard?
- The USDA Food Guide Pyramid from 1992
- Recommended Dietary Allowances (RDAs) / Dietary Reference Intakes (DRIs) (Correct answer)
- The facility's own internal calorie guidelines
- State agriculture department minimums only
Correct answer: Recommended Dietary Allowances (RDAs) / Dietary Reference Intakes (DRIs)
Federal regulations require nursing facility menus to meet the Recommended Dietary Allowances or Dietary Reference Intakes established by the National Academy of Sciences.
Question 4: An 'NDD' notation on a nursing facility resident's dietary record most commonly refers to which type of diet?
- No Dairy Diet
- No Documented Diagnosis
- National Dysphagia Diet (Correct answer)
- Nutritionally Dense Diet
Correct answer: National Dysphagia Diet
NDD stands for National Dysphagia Diet, a standardized texture and liquid modification framework used to reduce aspiration risk in residents with swallowing difficulties.
Question 5: Which professional is legally qualified to assess, diagnose, and treat swallowing disorders (dysphagia) in nursing facility residents in the US?
- Registered dietitian
- Certified dietary manager
- Speech-language pathologist (Correct answer)
- Licensed practical nurse
Correct answer: Speech-language pathologist
Speech-language pathologists (SLPs) are the licensed professionals qualified to evaluate and treat dysphagia and prescribe appropriate texture and liquid modifications.
Question 6: In a long-term care facility, therapeutic diets (such as low-sodium or diabetic diets) must be ordered by whom?
- The certified dietary manager
- A licensed physician or other authorized prescriber (Correct answer)
- The director of nursing
- The facility administrator
Correct answer: A licensed physician or other authorized prescriber
Therapeutic diets are medical orders and must be prescribed by a licensed physician or other authorized prescriber (e.g., NP or PA) and documented in the clinical record.
CSA CSA Dietary & Nutrition Services 1
Under 42 CFR §483.60, what is the minimum frequency with which a qualified dietitian must assess residents in a Medicare/Medicaid-certified nursing facility?