Last updated on June 15th, 2023
Welcome back to our F-tag food safety series. In previous installments of this series, we’ve discussed how to prepare your kitchen for inspections, how to ensure menus meet resident needs, how to create meals that match resident assessment plans, and more.
In this blog post, we’ll be exploring tag F-809, which centers on the frequency of meals. The tag states that:
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- Each resident must receive, and the facility must provide at least three meals daily, at regular times comparable to normal mealtimes in the community or in accordance with resident needs, preferences, requests, and plan of care.
- There must be no more than 14 hours between a substantial evening meal and breakfast the following day, except when a nourishing snack is served at bedtime. Up to 16 hours may elapse between a substantial evening meal and breakfast the following day if a resident group agrees to this meal span.
- Suitable, nourishing alternative meals and snacks must be provided to residents who want to eat at non-traditional times or outside of scheduled meal service times, consistent with the resident plan of care.
What is a Nourishing Snack?
Before we dive into the tag more, let’s clear up some definitions essential to understanding this tag’s intention.
CMS says a “nourishing snack” means it’s from the basic food groups either singly or in combination. Basically, the snack needs to provide a balance of nutrition, and it has to have a calorific value consistent with the resident’s diet. It also must have the protein, vitamins, and minerals to needed to promote good health.
During an inspection, the adequacy of the “nourishing snack” is determined both by resident interviews with a food surveyor (for example, they may ask, “Is the snack usually satisfying?”) and by evaluating the overall nutritional status of the community’s residents.
When CMS refers to “suitable and nourishing alternative meals and snacks,” they mean that when an alternate meal or snack is provided, it is of similar nutritional value as the meal or snack offered at the normally scheduled time and consistent with the resident plan of care.
If the regular menu option for the day isn’t something a resident wants to eat, your dining team needs to provide an alternative item to fit their nutritional needs. It is solely your responsibility to have these options available at each mealtime.
What’s the Purpose of the F-809 Tag?
This tag helps guide senior living communities toward more person-centered care because the wording is focused on the resident’s choices. Your community’s dining team needs to ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. The nourishing alternatives we discussed above must be available for residents who want to eat at non-traditional times or outside scheduled meal times. These guidelines give residents more say in when, where, and how they eat.
This regulation isn’t intended to require senior living communities to provide a 24-hour, full-service food operation (although we have seen more and more communities offer this). Suitable alternatives could be meals prepared in advance that can be appropriately served by trained staff members at non-traditional times.
How To Comply With the F-809 Tag
Now that you know more about what the F-809 tag actually requires, look at your own procedures and see if they line up with these CMS guidelines. Observe meal times and schedules and determine if they are offered at regular times throughout the community. You should also interview residents to get their input on meal service schedules to learn if the schedules and items offered meet their preferences. Get their input regarding eating at non-traditional times and the availability of snacks throughout the day.
Because this tag focuses so much on person-centered care, a surveyor will most likely interview your residents to determine how well your community is complying. They may ask them if they like the food you serve, how often you serve it, and whether or not the meals and snacks are satisfying. They could also ask residents if they are offered snacks at bedtime and if snacks are not provided, would they want them?
The surveyors may ask your dining team the following questions:
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- Are three meals offered at regular times?
- Are snacks and meals available for residents at non-traditional times or outside of scheduled meal service times, or upon request?
To ace your inspection, you should also be keeping track of your truck delivery log so you have records for the surveyor to review. Also, think about how you’re documenting snack/nourishment delivery. If you don’t have a process for documenting this, consider developing one and training your entire team on it and the time requirements for meals and snacks.
Consider establishing a process for late meals too. Who do you alert if a meal is going to be late? How late is too late? Do your meals/snacks have a buffer?
If you’d like some help creating these processes and ensuring you’re complying with the F-809 tag, the Culinary Services Group team is there for you. We can help you develop nourishing meals and snacks that meet resident preferences and also help you establish a schedule for serving food that matches the standards set by CMS.
We take our commitment to food safety so seriously that if you sign a contract with us and receive a moderate to a serious violation that requires another inspection, we’ll forgo our management fees until the problem is resolved and your community passes inspection.
If you’d like to learn more about how we can help your dining team stay compliant with the F-809 tag, contact us here.
