481—51.15(135B) Food and nutrition service.
	51.15(1) Food and nutrition service definition. “Food service” means providing safe, satisfying, and nutritionally adequate food for patients through the provision of appropriate staff, space, equipment, and supplies. “Nutrition service” means providing assessment and education to ensure that the nutritional needs of the patients are met.
	51.15(2) General requirements.
	a. 	All food will be handled, prepared, served, and stored in accordance with the Food Code adopted under provisions of Iowa Code section 137F.2.
	b. 	The food and dietetic services shall be of a quality and quantity to meet the patient’s needs in accordance with any qualified health practitioner’s orders and meet the standards set forth in 42 CFR 482.28 as amended to November 7, 2023. Patient food preferences should be respected as much as possible, and substitutes offered through use of appropriate food groups.
	c. 	Policies and procedures shall be developed and maintained.
	d. 	Not less than three meals will be served daily unless contraindicated, and not more than 14 hours will elapse between the evening meal and breakfast of the following day. Nourishment between meals will be available to all patients unless contraindicated by the qualified health care practitioner.
	e. 	The hospital will maintain adequate space, equipment, and staple food supplies to provide patient food service in emergencies.
	f. 	Menus for regular and therapeutic diets will be available and standardized recipes with nutritional analysis adjusted to number of portions will be maintained and used in food preparation.
	g. 	Food shall be prepared by methods that conserve nutritive value, flavor, and appearance. Food shall be served attractively at appropriate and safe temperatures and in a form to meet individual needs.
	h. 	Nutrition screening will be conducted by qualified hospital staff to determine the patient’s need for a comprehensive nutrition assessment by the licensed dietitian. Nutritional care will be integrated in the patient care plan, as appropriate, based upon the patient’s diagnosis and length of stay. The licensed dietitian will record in the patient’s medical record any observations and information pertinent to medical nutrition therapy, and any pertinent dietary records will be included in the patient’s transfer discharge record to ensure continuity of nutritional care. Upon discharge, nutrition counseling and education will be provided to the patient and family as ordered by the qualified health care practitioner, requested by the patient or deemed appropriate by the licensed dietitian.
	i. 	In-service training, in accordance with hospital policies, will be provided for all food and nutrition service personnel.
	j. 	On the nursing units, a separate patient food storage area will be maintained that ensures proper temperature control.
	51.15(3) Food and nutrition service staff.
	a. 	A licensed dietitian will be employed on a full-time, part-time or consulting basis, with any part-time or consultant services provided on the premises at appropriate times on a regularly scheduled basis. These services shall be of sufficient duration and frequency to provide continuing liaison with medical and nursing staff, advice to the administrator, patient counseling, guidance to the supervisor and staff of the food and nutrition service, approval of all menus, and participation in the development or revision of departmental policies and procedures and in planning and conducting in-service education programs.
	b. 	If a licensed dietitian is not employed full-time, then one must be employed on a part-time or consultation basis with an additional full-time person who has completed a certified dietary manager course and is employed to be responsible for the operation of the food service.
	c. 	Sufficient food service personnel will be employed, oriented, trained, and their working hours scheduled to provide for the nutritional needs of the patients and to maintain the food service areas.
	51.15(4) Food service equipment and supplies. Equipment necessary for preparation and maintenance of menus, records, and references will be provided. At least one week’s supply of staple foods and a reasonable supply of perishable foods shall be maintained on the premises. Supplies will be appropriate to meet the requirements of the menu.
[ARC 7573C, IAB 2/7/24, effective 1/18/24]