PURPOSE: This rule establishes standards for meeting dietary needs of residents in residential care facilities I and II. Editor’s Note: All rules relating to long-term care facilities licensed by the Division of Aging are followed by a Roman Numeral notation which refers to the class (either class I, II or III) of standard as designated in sec- 10, 1988. Moved to 19 CSR 30-86.052, effection 198.085.1, RSMo 1986. tive Aug. 28, 2001. (1) The nutritional needs of the residents *Original authority: 198.076, RSMo 1979, amended 1984. shall be met. Balanced nutritious meals using a variety of foods shall be served. Consideration shall be given to the food habits, preferences, medical needs and physical abilities of the residents. II/III (2) At least three (3) substantial meals per day, of which at least two (2) are hot, shall be served. II/III (3) Meals shall be served with not more than fourteen (14) hours from evening meal to morning meal. III (4) Fresh water shall be available to the resident at all times. II/III

1. (5) Dining room service for residents shall be attractive and each resident shall receive appropriate table service. III
2. (6) Menus shall be planned in advance and shall be readily available for personnel involved in food purchase and preparation. Food shall be served as planned although substitutes of equal nutritional value and complementary to the remainder of the meal can be made if recorded. III
3. (7) A three (3)-day supply of food shall be maintained in the facility. III

4. (8) If a physician prescribes in writing a modified diet for a resident, the resident may be accepted or remain in the facility if—

   1. (A) The physician monitors the resident’s condition on a regular periodic basis and at least quarterly; II
   2. (B) The diet, food preparation and serving is reviewed at least quarterly by a consulting nutritionist, dietitian, registered nurse or physician and there is written documentation of the review; II/III
   3. (C) The modified diet menu is posted in the kitchen and includes portions to be served; III and
   4. (D) The facility has entered into a written agreement for dietary consultation with a nutritionist, dietitian registered nurse or physician. III

AUTHORITY: section 198.076, RSMo 1986.* This rule originally filed as 13 CSR 15- 15.052. Original rule filed July 13, 1983, effective Oct. 13, 1983. Emergency amendment filed Aug. 1, 1984, effective Aug. 13, 1984, expired Dec. 10, 1984. Amended: Filed Sept. 12, 1984, effective Dec. 13, 1984. Amended: Filed Aug. 1, 1988, effective Nov.