SMQT Dietary and Nutrition Services 3 — Questions and Answers
Question 1: During a kitchen observation, a surveyor notices a food service worker handling raw chicken and then preparing a cold salad without washing hands or changing gloves. This practice PRIMARILY violates which food safety principle?
- Temperature control
- Cross-contamination prevention (Correct answer)
- Proper thawing procedures
- Pest control standards
Correct answer: Cross-contamination prevention
Moving from raw poultry to ready-to-eat foods without hand hygiene or glove change is a direct cross-contamination risk, a critical food safety violation.
Question 2: A surveyor reviews a resident's care plan and notes that hydration goals are not documented despite the MDS indicating the resident is at risk for dehydration. The MOST relevant F-tag is:
- F636 – Comprehensive Assessments
- F675 – Quality of Life
- F692 – Nutritional Status
- F656 – Comprehensive Care Plans (Correct answer)
Correct answer: F656 – Comprehensive Care Plans
F656 requires that care plans address identified needs including hydration, so an absent hydration goal for a resident at risk violates the comprehensive care plan requirement.
Question 3: When evaluating a facility's food purchasing practices, a surveyor finds that ground beef was received and stored without documentation of safe handling temperature during transport. Under F812, facilities must ensure food is:
- Purchased only from local farms
- Procured from sources that comply with applicable laws relating to food safety (Correct answer)
- Inspected by a licensed dietitian before use
- Cooked within 24 hours of delivery
Correct answer: Procured from sources that comply with applicable laws relating to food safety
F812 requires that food is obtained from sources that comply with applicable food safety laws, ensuring safe procurement from regulated suppliers.
Question 4: A surveyor observes that a resident with late-stage dementia is losing weight and staff report the resident 'won't eat.' The FIRST appropriate clinical step the facility should take is:
- Insert a PEG tube immediately
- Conduct a comprehensive eating assessment including observation during a meal (Correct answer)
- Discontinue all nutritional supplements
- Change all meals to a pureed diet without assessment
Correct answer: Conduct a comprehensive eating assessment including observation during a meal
Before any intervention, a systematic eating assessment including mealtime observation identifies the root cause (positioning, food preferences, oral health, swallowing) of intake decline.
Question 5: Federal regulations require that the interval between the evening meal and breakfast the next morning should not exceed:
- 10 hours
- 12 hours
- 14 hours (Correct answer)
- 16 hours
Correct answer: 14 hours
CMS regulations under F809 prohibit more than 14 hours between the evening meal and the next morning's breakfast to ensure adequate nutrition.
Question 6: A surveyor reviewing a facility's infection control practices notes that dietary staff are not wearing hair restraints while preparing food. This finding MOST directly relates to:
- F812 – Food Procurement/Store/Prepare/Serve-Sanitary (Correct answer)
- F880 – Infection Prevention and Control
- F803 – Menus and Nutritional Adequacy
- F940 – Staff Training
Correct answer: F812 – Food Procurement/Store/Prepare/Serve-Sanitary
F812 covers sanitary food preparation practices including personal hygiene measures such as hair restraints for food service staff.
Question 7: A resident's MDS assessment documents 'weight loss' but the care plan has no corresponding goal or intervention. During the survey, the surveyor should cite this as a deficiency under which regulatory area?
- Staffing deficiency
- Comprehensive care plan deficiency (Correct answer)
- Medical records deficiency
- Physician order deficiency
Correct answer: Comprehensive care plan deficiency
Failure to develop a care plan goal and intervention in response to an identified weight loss is a comprehensive care plan deficiency under F656.
SMQT Dietary and Nutrition Services 3
During a kitchen observation, a surveyor notices a food service worker handling raw chicken and then preparing a cold salad without washing hands or changing gloves.
This practice PRIMARILY violates which food safety principle?