Page 81 - The Deep Seated Issue of Choice

THE DEEP SEATED ISSUE OF CHOICE
APPENDIX D
F366
483.35(d)(3)(4)
Probes
Add probe guidance to affirm the resident right to refuse substitutions of equal nutritional value and instead receive foods of personal preference.
F367
483.35(e)
Intent
Change receives and consumes to offered foods in the appropriate form and/or the appropriate nutritive content...
F368
Intent – Interpretive Guidelines - Procedures
Clarify that the availability 24/7 of foods of resident choice, including high quality protein, offered and served by staff according to care plan preference for alternative meal times is an acceptable accommodation of frequency of meals.
F371
483.35(i)(2)
Factors Implicated in Food Borne Illnesses
Food Handling and Preparation
Expand guidance to clarify reasonable expectations and identify acceptable procedures regarding food service by non-food service staff in decentralized kitchens and dignified resident assistance in dining. Consider the standard of compliance with standard precautions as appropriate in all circumstances.
Food Receiving and Storage
Include the clarified guidance from Memorandums clarifying the acceptance of food from outside sources. Address the expectations for maintaining safe refrigerated storage in resident rooms, as well as safe storage of residents personal food in facility refrigerators.
F373
483.35(h)
Expand paid feeding assistants to all states through federal guidance.
F385
483.40
Interpretive Guidelines
Expand definition of supervising medical care to include education of residents on the risks and benefits of treatment options and honoring resident right to self-determination in treatment choice.
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