Section 390.1840 Diet Orders

Section 390

Section 390.1840  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 dietary, 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.  Any

significant changes in weight shall be  reported to the dietitian.

e)         A therapeutic diet means a diet ordered by the physician as

part of 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 dietitian.

g)         The kinds and variations of prescribed therapeutic diets shall

be available in the kitchen

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 dietitian.

g)         The kinds and variations of prescribed therapeutic diets shall

be available in the kitchen.  If separate menus are not planned for each specified

diet, information for each specified 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.