[Code of Federal Regulations]
[Title 38, Volume 2]
[Revised as of July 1, 2003]
From the U.S. Government Printing Office via GPO Access
[CITE: 38CFR51.140]

[Page 834-835]
 
            TITLE 38--PENSIONS, BONUSES, AND VETERANS' RELIEF
 
          CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS (CONTINUED)
 
PART 51--PER DIEM FOR NURSING HOME CARE OF VETERANS IN STATE HOMES--Table 
of Contents
 
                          Subpart D--Standards
 
Sec. 51.140  Dietary services.

    The facility management must provide each resident with a 
nourishing, palatable, well-balanced diet that meets the daily 
nutritional and special dietary needs of each resident.
    (a) Staffing. The facility management must employ a qualified 
dietitian either full-time, part-time, or on a consultant basis.
    (1) If a dietitian is not employed, the facility management must 
designate a person to serve as the director of food service who receives 
at least a monthly scheduled consultation from a qualified dietitian.
    (2) A qualified dietitian is one who is qualified based upon 
registration by the Commission on Dietetic Registration of the American 
Dietetic Association.
    (b) Sufficient staff. The facility management must employ sufficient 
support personnel competent to carry out the functions of the dietary 
service.
    (c) Menus and nutritional adequacy. Menus must--
    (1) Meet the nutritional needs of residents in accordance with the 
recommended dietary allowances of the Food and Nutrition Board of the 
National Research Council, National Academy of Sciences;
    (2) Be prepared in advance; and
    (3) Be followed.
    (d) Food. Each resident receives and the facility provides--

[[Page 835]]

    (1) Food prepared by methods that conserve nutritive value, flavor, 
and appearance;
    (2) Food that is palatable, attractive, and at the proper 
temperature;
    (3) Food prepared in a form designed to meet individual needs; and
    (4) Substitutes offered of similar nutritive value to residents who 
refuse food served.
    (e) Therapeutic diets. Therapeutic diets must be prescribed by the 
primary care physician.
    (f) Frequency of meals. (1) Each resident receives and the facility 
provides at least three meals daily, at regular times comparable to 
normal mealtimes in the community.
    (2) There must be no more than 14 hours between a substantial 
evening meal and the availability of breakfast the following day, except 
as provided in (f)(4) of this section.
    (3) The facility staff must offer snacks at bedtime daily.
    (4) When a nourishing snack is provided at bedtime, up to 16 hours 
may elapse between a substantial evening meal and breakfast the 
following day.
    (g) Assistive devices. The facility management must provide special 
eating equipment and utensils for residents who need them.
    (h) Sanitary conditions. The facility must--
    (1) Procure food from sources approved or considered satisfactory by 
Federal, State, or local authorities;
    (2) Store, prepare, distribute, and serve food under sanitary 
conditions; and (3) Dispose of garbage and refuse properly.

(Authority: 38 U.S.C. 101, 501, 1710, 1741-1743)