Dietary and Nutrition Services Flashcards

A surveyor reviews a facility where enteral tube feeding is used for a cognitively intact resident who had not consented to this intervention. This scenario MOST directly raises concerns under:

Answer: F578 – Request/Refuse Treatment; Formulate Advance Directives

A cognitively intact resident has the right to refuse any treatment including tube feeding; proceeding without consent violates F578 (right to refuse treatment).

During a dietary observation, a surveyor notes that thickened liquids ordered for a resident with dysphagia are being prepared inconsistently by different staff members. The MOST appropriate system-level corrective action is:

Answer: Develop a standardized protocol with pre-measured thickening agent quantities and competency training

Consistent thickened liquid preparation requires standardized protocols with precise measurements and staff competency validation to ensure resident safety.

A facility's food safety log shows that a steam table was holding mashed potatoes at 130°F during lunch service. The required minimum hot holding temperature for cooked foods is:

Answer: 135°F

The FDA Food Code requires hot foods to be held at 135°F or above to prevent bacterial growth in the temperature danger zone.

A surveyor is evaluating a facility's nutritional supplement program and finds that supplements ordered by the dietitian are routinely given between meals but never documented in the medical record. This is MOST likely a deficiency in:

Answer: F842 – Medical Records

Failure to document supplement administration in the medical record is a medical records deficiency under F842, as all interventions must be documented.

A resident at high risk for aspiration is found eating in the supine position without staff supervision. The MOST immediate concern for the surveyor is:

Answer: Imminent danger to the resident's health and safety

A resident at high aspiration risk eating supine without supervision represents an immediate jeopardy situation due to the high likelihood of aspiration pneumonia or asphyxiation.

Under OBRA regulations, the role of the dietitian in a SNF includes all of the following EXCEPT:

Answer: Prescribing medications to treat malnutrition

Dietitians are not licensed to prescribe medications; their scope includes assessment, care planning, education, and nutritional intervention, not pharmacological prescription.

A surveyor observes that a resident with diabetes who requires carbohydrate-consistent meals consistently receives the standard menu without any modification. The facility's dietitian states no order is on file for a diabetic diet. The NEXT appropriate step in the survey process is:

Answer: Review the resident's medical records to determine if a physician order for a diabetic diet exists or was indicated

Before citing a deficiency, the surveyor must verify the facts by reviewing the medical record to determine whether a diet order was indicated, ordered, or properly refused by the resident.