This regulation requires nursing facilities to prepare and serve food in ways that preserve nutritive value, flavor, and appearance, and to provide food and drink that is palatable, attractive, and at a safe and appetizing temperature. Facility operators must use proper storage, cooking, and holding methods to minimize nutrient loss and ensure resident satisfaction. Surveyors assess compliance through test trays, recipe reviews, resident interviews, and observation of meal service.
View official sourceF804 (Rev. 173, Issued: 11-22-17, Effective: 11-28-17, Implementation: 11-28-17) §483.60(d) Food and drink Each resident receives and the facility provides— §483.60(d)(1) Food prepared by methods that conserve nutritive value, flavor, and appearance; §483.60(d)(2) Food and drink that is palatable, attractive, and at a safe and appetizing temperature. INTENT §483.60(d)(1)-(2) - To assure that the nutritive value of food is not compromised and destroyed because of prolonged: (1) Food storage, light, and air exposure; or (2) Cooking of foods in a large volume of water; or (3) Holding on steam table. DEFINITIONS §483.60(d)(1)-(2) “Food attractiveness” refers to the appearance of the food when served to residents. “Food palatability” refers to the taste and/or flavor of the food. “Proper (safe and appetizing) temperature” means both appetizing to the resident and minimizing the risk for scalding and burns. GUIDANCE §483.60(d)(1)-(2) Food should be palatable, attractive, and at an appetizing temperature as determined by the type of food to ensure resident’s satisfaction, while minimizing the risk for scalding and burns. Providing palatable, attractive, and appetizing food and drink to residents can help to encourage residents to increase the amount they eat and drink. Improved nutrition and hydration status can help prevent, or aid in the recovery from, illness or injury. PROCEDURES §483.60(d)(1)-(2) If there are complaints concerning food temperatures, palatability, or attractiveness from residents or through group interviews, observations of food not being eaten, or delay in passing of food trays, request a test tray from the dining area, floor or unit of most concern. In addition; • Review recipes, if needed, to determine if non-compliance exists. • If a test tray was obtained, how did it support resident or observed concerns? PROBES §483.60(d)(1)-(2) • Does food have a distinctly appetizing aroma and appearance, which is varied in color and texture? • Is food generally well-seasoned (use of spices, herbs, etc.) and acceptable to residents? If not, did the facility ensure all ingredients were available to make recipes as instructed for palatability? • Is food prepared in a way to preserve vitamins? Method of storage and preparation should cause minimum loss of nutrients. For example, foods are prepared as directed or not held at hot temperatures for hours prior to meal service because prolonged hot temperatures can result in a loss of vitamins. • Is food served at preferable temperature for the resident (hot foods are served hot and cold foods are served cold and in accordance with resident preferences). (Not to be confused with the proper holding temperature. Refer to §483.60(i) food safety requirements. • Was the facility aware of the resident(s) complaint(s) about the food through resident council, the grievance/complaint process at the facility, or communication directly with staff? What did facility do to address the complaint(s)?