This F-Tag requires nursing facilities to employ sufficient food and nutrition service staff with appropriate competencies, taking into account resident assessments, plans of care, and resident acuity. Support personnel must be adequate to safely carry out meal preparation and food service functions, and a food and nutrition services staff member must participate in interdisciplinary team meetings. Surveyors assess staffing adequacy through observations and interviews focused on meal quality, timeliness, temperature, and resident preferences.
View official sourceF802 (Rev. 225; Issued: 08-08-24; Effective: 08-08-24; Implementation: 08-08-24) §483.60(a) Staffing The facility must employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, taking into consideration resident assessments, individual plans of care and the number, acuity and diagnoses of the facility’s resident population in accordance with the facility assessment required at §483.71. §483.60(a)(3) Support staff. The facility must provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. §483.60(b) A member of the Food and Nutrition Services staff must participate on the interdisciplinary team as required in § 483.21(b)(2)(ii). DEFINITION §483.60(a)(3)-(b) “Sufficient support personnel” means having enough dietary and food and nutrition staff to safely carry out all of the functions of the food and nutrition services. This does not include staff, such as licensed nurses, nurse aides or paid feeding assistants, involved in assisting residents with eating. PROCEDURES §483.60(a)(3) and (b) • Through observations and interviews determine if there are sufficient support personnel to safely and effectively carry out the meal preparation and other food and nutrition services as defined by facility management. • Observe and interview residents to determine if their needs and preferences are met, if the food is palatable, attractive, served at the proper temperatures and at appropriate times? If concerns are identified, determine if they may be related to insufficient or inadequately trained personnel. • Do observations and/or interviews indicate there are sufficient staff to prepare and serve meals in a timely manner and to maintain food safety and temperature? • Determine who represents food and nutrition services at interdisciplinary team meetings. When evaluating timeliness, factors that should be considered include but may not be limited to: • Meals or nutritional supplements are provided in accordance with a resident’s medication requirements; • Meals intended to be “hot” are served as such and are maintained at the desired temperature when provided to the resident; • Meals or nutritional supplements are provided to residents within 45 minutes of either a residents request or less depending on the facility’s scheduled time for meals. If a concern with having sufficient staff is identified, determine if the staffing levels provided were based on the facility assessment. If a concern with the facility assessment is identified, see §483.71, F838, Facility Assessment.