Culture Change in Nursing Homes

Pioneer Network Food and Dining Clinical Standards Task Force Summary

Food and dining regulations are very important to quality living in nursing homes. The Centers for Medicare and Medicaid Services (CMS) notes that the most frequent questions received concern dining and food policies. Therefore, in 2010, Pioneer Network and CMS held Creating Home in the Nursing Home II: A National Symposium on Culture Change and the Food and Dining Requirements. One recommendation that came from the symposium was the formation of a national stakeholder workgroup charged with developing standards of practice that help shift nursing home culture from traditional diagnosis-focused treatment to individualized care supportive of self-directed living. View the CMS New Dining Practice Standards Memorandum Talking Points developed for ASHA members.

The workgroup, convened by Pioneer Network with the support of the Hulda B. and Maurice L. Rothschild Foundation, developed a draft of proposed new dining pratice standards. The standards focused on the following topics:

  • Diet Liberalization
  • Diabetic/Calorie Controlled Diet
  • Low Sodium Diet
  • Cardiac Diet
  • Altered Consistency Diet
  • Tube Feeding
  • Real Food First
  • Honoring Choice
  • Shifting Traditional Professional Control to Support Self Directed Living
  • New Negative Outcome

The proposed standards were then reviewed and revised by the Food and Dining Clinical Standards Task Force, made up of representatives from professional organizations as well as relevant government agencies, including:

  • American Dietetic Association
  • American Medical Directors Association
  • American Occupational Therapy Association
  • American Society of Consultant Pharmacists
  • American Speech-Language-Hearing Association
  • Centers for Disease Control
  • Centers for Medicare & Medicaid Services
  • Coalition of Geriatric Nursing Organizations
  • Dietary Managers Association
  • Food and Drug Administration
  • National Association of Directors of Nursing Administration (NADONA)
  • National Association of Health Care Assistants

The final version of the standards are available on the Pioneer Network website. The standards will be submitted to CMS, FDA, CDC and the long-term care community at large. It is the goal of the Task Force that surveyors, clinicians, and interdisciplinary team members will put these new standards into practice.

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