Page 50 - Ombudsman Participant Manual Optimized_Neat

when the meals are delivered to the unit and when they are then

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delivered o the individual residents. This can sometime be the

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issue with food temps at mealtimes. meal needs to be re-

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heated resident is preferring an alternate item/is missing
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an item, etc. – nursing would usually handle that. They would

reheat the meal and contact dietary for additional or alternative

items. When nursing staff are rushing or moving quickly/feeling

overwhelmed, they may offer to return after the rest of the trays

are delivered and then forget/fail to do so.

Dietician The dietician doesn’t do the cooking. They are the clinician who

makes sure everyone is receiving a clinically appropriate diet –

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based n diagnoses, medical need, physicians’ orders, etc.
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not unusual for smaller nursing homes to have a part-time or

regional dietician who comes in on a routine basis to

review/check orders, etc. Tip: The regulations state that a

resident must be offered/provided a therapeutic diet. The

regulations o NOT say that a resident must eat a therapeutic

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diet. Dietary options / consequences of choices should be

explained o resident and the resident should have significant

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input regarding their menu and food preferences.
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Dietary Manager The person n charge of the dietary department. Orders food;

establishes the menu; supervises and schedules staff; coordinates

Dietician and Dietary department. TIP: Dietary managers often

establish menus for the entire facility based on budgets,

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availability f supplies/storage/preparation requirements. The

dietary manager is a great person to go to with resident council

issues regarding selection, food quality, food temps, etc. n some

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facilities, there are food committees of residents who meet

routinely with the dietary manager to facilitate resident direction

regarding menus, etc.

RNAC / Registered Nurse Assessment Coordinator The RNAC often functions as the care plan “gatekeeper”. They

create a schedule of care plans that need review – either routine

review or review for a significant change – and they share that

schedule with the staff that need to participate. Before a care
plan meeting occurs, there are several assessments that must be

completed y several different modalities. The results of these

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assessments create a document of “triggers” – indicating items

that need to be addressed on the care plan itself. These moving

parts are very important in terms of regulatory compliance and

reimbursement. Once the Triggers are identified, a care plan is

created listing the “problems”, the “goals” and the interventions.

Then the team meets to finalize the plan of care at the care plan

meeting. The care plan meeting is an EXCELLENT way for

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residents o understand their options, direct their care, and

express their goals. Remember that a care plan “tip sheet” is an

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available resource for l our ombudsman. The intent of the tip

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sheet o help our ombudsmen understand the care plan

process n order that they can better advise residents on their
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rights n this regard.
Office of the LTC Ombudsman
Office of the LTC Ombudsman
Version 1.0 September 2020
Version 1.0 September 2020
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