Section 225.6030  Diet Orders

a)         Two or more copies of a current diet manual shall be available and in use. One copy shall be located in the kitchen for use by dietary personnel.  Other copies shall be located at each nurses' station for use by physicians when prescribing diets.

b)         Physicians shall write a diet order, in the medical record, for each resident indicating whether the resident is to have a general or a therapeutic diet. The diet shall be served as ordered.

c)         A written diet order shall be sent to the food service department when each resident is admitted and each time that the resident's diet is changed. Each change shall be ordered by the physician.  The diet order shall include, at a minimum, the following information:  name of resident, room and bed number, type of diet, consistency if other than regular consistency, date diet order is sent to the dietary department, name of physician ordering the diet, and the signature of the person transmitting the order to the food service department.

d)         The resident shall be observed to determine acceptance of the diet, and these observations shall be recorded in the medical record.

e)         A therapeutic diet means a diet ordered by the physician as part of a treatment for a disease or clinical condition, to eliminate or decrease certain substances in the diet (e.g., sodium) or to increase certain substances in the diet (e.g., potassium), or to provide food in a form that the resident is able to eat (e.g., mechanically altered diet).

f)         All therapeutic diets shall be medically prescribed and shall be planned or approved by a dietician.

g)         The kinds and variations of prescribed therapeutic diets shall be available in the kitchen.  If separate menus are not planned for each specific diet, diet information for each specific type, in a form easily understood by staff, shall be available in a convenient location in the kitchen.

h)         All oral liquid diets shall be reviewed every 48 hours.  Medical soft diets, sometimes known as transitional diets, shall be reviewed every three weeks. All other therapeutic and mechanically altered diets, including commercially prepared formulas that are in liquid form and blenderized liquid diets, shall be reviewed as needed, or at least every three months.

i)          The resident's physician, the food service director, the charge nurse, and the nursing assistants shall be made aware of any resident's feeding difficulties.

j)          Each resident shall be weighed every two weeks, and the resident's weight shall be recorded in the medical chart.