Dietary and Nutrition Services Flashcards

Under CMS F-tag F803, a nursing facility's menus must be planned and followed with sufficient variety to meet residents' needs and preferences. What is the minimum number of meals that must be offered each day?

Answer: 3 meals plus snacks as needed

CMS requires at least three meals per day plus snacks between meals and at bedtime as needed to meet residents' nutritional needs.

A surveyor observes that a resident on a sodium-restricted diet is consistently receiving meals that do not comply with the ordered diet. Which F-tag is MOST directly implicated?

Answer: F804 – Nutritive Value/Appear/Palatable/Prefer Temp

F804 addresses the requirement that food must be prepared in a form designed to meet individual needs, including therapeutic diet orders.

When surveying a skilled nursing facility, a surveyor notices a resident's weight has dropped 8% over 30 days. Under MDS coding rules, this weight loss is classified as:

Answer: Significant weight loss

A weight loss of 5% or more over 30 days meets the MDS definition of significant weight loss, triggering further assessment.

A dietitian determines that a resident requires a mechanically altered diet due to dysphagia. The MOST appropriate texture level descriptor consistent with IDDSI framework for a resident who can manage soft, tender pieces is:

Answer: Minced and Moist (Level 5)

IDDSI Level 5 (Minced and Moist) is appropriate for residents who can manage small, soft, moist pieces but have mild chewing or swallowing difficulty.

During a dietary observation, a surveyor finds food stored at 48°F in the walk-in refrigerator. The required maximum safe refrigerator temperature for potentially hazardous foods under federal food safety standards is:

Answer: 41°F

Federal food safety guidelines and FDA Food Code require potentially hazardous foods to be held at 41°F or below to prevent bacterial growth.

A resident refuses the therapeutic diet ordered by the physician. After education on risks, the resident continues to refuse. The facility's CORRECT response under resident rights regulations is to:

Answer: Document the refusal and provide the resident's food preferences while informing the physician

Residents have the right to refuse treatment including therapeutic diets; the facility must document the refusal, notify the physician, and work to honor food preferences.

A certified dietary manager (CDM) is overseeing dietary operations in a SNF without a consultant dietitian on site. Under CMS regulations, which staffing arrangement is minimally acceptable?

Answer: A CDM may manage day-to-day operations if a qualified dietitian consults on a regularly scheduled basis

CMS allows a CDM to manage daily dietary services provided that a qualified dietitian provides regularly scheduled consultation to ensure clinical nutrition needs are met.