Long-Term Care Survey Alert

When it comes to accommodating residents mealtime preferences and routines, federal regulations offer more latitude than many providers think. Take, for example, the federal requirement that meals will be served at regular hours.

"Providers may interpret this to mean the need to serve meals at the same time every day," saysSteve Shields, executive director, Meadowlark Hills Retirement Community in Manhattan, KS.

But in talking it over with regulators, Meadowlark administrators found that the reg could also mean that the resident feels he has access to food at any time or that a resident chooses the mealtime thats regular for him based on his preferred lifestyle.

Facilities attempting to accommodate residents individual meal times also butt heads with the "14-hours rule, Shields says. " That one says no resident will go without food for more than 14 hours," he notes. "So if a resident wants to eat supper in his room at 4:30 p.m. and a custom-made breakfast at 10:30 the next day, thats more than 14 hours," Shields cautions.

Yet OBRA 87 provides latitude to meet resident needs within the framework of their right to choose. "So we would in that case explain to the resident or his legal guardian the risks of going without food that long," Shields explains. But if the resident still chose that schedule, Meadowlark would honor her choice. "Most residents respond to information about the risks by saying, Honey, I lived to be this old following that routine."