Section 52.44. Nutrition.

 

(1)   Meals and snacks.

(a) A center shall provide or arrange for each resident to receive at least 3 meals each day. Meals shall be served at regular times comparable to normal mealtimes in the community.

(b) Food served at a meal shall consist of adequate portions based on the ages of residents. Lunch and breakfast meals shall follow the meal pattern requirements for the national school lunch program as provided by the U.S. department of agriculture and included in Appendix C of this chapter. Dinner meals shall be comparable to the lunch meal pattern requirements.

(c) Nutritious snacks shall be provided between meals to residents at the center as follows:

1. For residents between breakfast and lunch if there are more than 4 hours between those meals, and between lunch and dinner.

2. For all residents, an evening snack.

3. When a resident's nutritional care plan under sub. (2) (c) indicates a need for snacks.

(2)   Residents with special dietary needs. A center shall maintain an up-to-date list of residents with special nutritional or dietary needs as determined by a physician or dietitian, and shall do all of the following:

(a) Provide food supplements or modified diets as ordered by a physician for a resident who has special dietary needs.

(b) Have procedures for recording diet orders and changes and for sending diet orders and changes to kitchen personnel.

(c) Include a nutritional care plan in the health record of a resident with special nutritional or dietary needs. The plan shall include a problem statement, nutritional goals or dietary goals, a plan of action and procedures for follow-up. The nutritional care plan shall be reviewed and approved by a registered dietitian.

(d) Provide adaptive self-help devices to residents as needed and instruct residents on their use.

(e) Observe resident food and fluid intake. Review acceptance by a resident of a diet, and report any significant deviations from a resident's normal eating pattern to the resident's physician.

(f) Assist residents with food and fluid intake as necessary according to the nutritional care plan, including where applicable such tasks as instructing a resident on how to eat and take fluids as independently as possible and protecting a resident from choking which may occur because of a physiological or behavioral eating disorder.

(g) Provide vitamin and mineral supplements when ordered by a physician.

(3)   Menus. A center shall do all of the following:

(a) Plan meals and snacks in advance of the date of service and prepare menus in writing that specify the actual food to be served.

(b) Post the menu for the day and next day in the food serving area or in another place where residents can read it.

(c) Keep menus on file for the last 30 days of service.

(d) When it is necessary to substitute another item for an item on a posted menu, ensure that the replacement item has the same nutritional value as the item replaced. The center shall provide for menu substitutes where religious beliefs prohibit consumption of certain food items such as pork for Jewish or Muslim residents or meat products on Lenten Fridays or other designated days of fast for Catholic residents.

(4)   Food service personnel.

(a) In this subsection, "food service personnel" means staff who prepare breakfast, lunch, dinner and snacks for center residents.

(b) If a center has its own food service personnel, the food service personnel shall be age 18 or over and meet the requirements of s. DHS 190.09 (1) .

(c) The director of a center shall appoint a food service director who shall be responsible for complying with this section and ch. DHS 190 as it relates to food service.

(d) A center shall provide all center food service personnel in-service training annually. Training topics shall relate to proper food handling procedures, maintenance of sanitary conditions and food service arrangements. Training shall be documented and the documentation kept on file at the center.

(5)   Food service.

(a) A center shall meet the requirements of s. DHS 190.09 (2) to (9) .

(b) A center shall provide nutritious packed lunches for residents who are in school or vocational or work programs when on-site lunches are not available. The center shall make provision for holding a meal for a resident who returns to the center after a meal is served.

(c) No resident may be force-fed or otherwise coerced to eat against the resident's will except by order of a physician.

(d) A staff person trained in the Heimlich maneuver for choking victims shall be present at mealtimes.

(e) Residents shall have at least 30 minutes to finish a meal, and a resident with an eating disorder shall have as much time as is necessary to finish the meal.

(f) The dining room in a center shall be clean, well-lighted and ventilated and shall offer a comfortable atmosphere for dining.

(g) A center may not use disposable dinnerware at meals on a regular basis, except when it documents that use of disposable dinnerware for a particular resident is necessary to protect the health or safety of the resident or others.

History: Cr. Register, February, 2000, No. 530 , eff. 9-1-00; corrections in (4) (b), (c) and (5) (a) made under s. 13.92 (4) (b) 7. , Stats., Register November 2008 No. 635 .

Note

An example of a food that has been fatal is peanut butter sandwiches for a Down Syndrome individual with uncontrollable eating habits. Microsoft Windows NT 6.1.7601 Service Pack 1