Ohio Admin. Code 5160-44-11 - Nursing facility-based level of care home and community-based services programs: home delivered meals
(A)
The following
definitions are applicable to this rule:
(1)
"Dietitian" and
"licensed dietitian" mean a person with a current, valid license to practice
dietetics under section
4759.06 of the Revised
Code.
(2)
"Home delivered meals" is a meal delivery service based
on an individual's need for assistance with activities of daily living (ADLs)
and/or instrumental activities of daily living (IADLs) in order to safely
prepare meals, or ensure meals are prepared to meet the individual's dietary
needs or specialized nutritional needs, including kosher meals. The type of
home delivered meals are the following
(a)
Standard meal
means a meal that adheres to the version of the "Dietary Guidelines for
Americans" in effect on the delivery day and at least thirty-three per cent of
the individual's dietary reference intakes. A standard meal may include, but is
not limited to, a reduced calorie meal, reduced sodium meal, reduced sugar
meal, a gluten-free meal, or vegetarian meal, if the individual chooses the
meal by personal preference.
(b)
Kosher meal is a
meal that complies with the kosher practices for meal preparation and dietary
restrictions and certified as kosher by a recognized kosher certification or a
kosher establishment under orthodox rabbinic supervision.
(c)
Therapeutic meal
means a meal provided in accordance to an order by a licensed healthcare
professional whose scope of practice includes ordering therapeutic diets:
(i)
For management of
a disease or clinical condition;
(ii)
To modify,
eliminate, decrease or increase certain substances in the diet;
or
(iii)
To provide mechanically altered food when
indicated.
(3)
"Meals" are
single portions that are ready to eat, frozen, vacuum-packed,
modified-atmosphere-packed, or shelf-stable. Meals have all the following
characteristics:
(a)
It includes instructions on how to safely maintain,
heat, reheat and/or assemble the meal, in a manner understandable to the
individual and/or their caregiver.
(b)
It adheres to the
individual's medical restrictions as set forth in their person-centered
services plan.
(B)
Meal
specifications.
(1)
Meal menus will be approved in writing by a dietitian
who is currently registered with the commission on dietetic registration, and
who is also a licensed dietitian in the state in which the dietitian is located
if that state licenses dietitians.
(a)
Providers will furnish each individual with home
delivered meals that accommodate the individual's religious, cultural, ethnic,
and dietary preferences.
(b)
Providers shall publish their current menu and
ingredient information on their websites and offer written menus and ingredient
information to individuals.
(2)
An individual's
person-centered services plan establishes meal delivery parameters which
include all the following:
(a)
Up to two meals per day. The maximum number of meals
delivered will not exceed fourteen meals at one time.
(b)
The type of
meal.
(c)
The frequency of delivery.
(d)
The
delivery-verification method which will include:
(i)
Signature upon
delivery by the individual or the individual's designee; or
(ii)
The delivery
driver's confirmation that delivery occurred. The provider may use an
electronic system to verify.
(a)
If a provider uses a common carrier to deliver meals, the
provider will verify the success of the delivery by using the method in
paragraph (B)(2)(d) of this rule; or
(b))
By retaining the common carrier's tracking statement or
other evidence showing successful delivery.
(e)
A
provider may deliver specifically identified items that are packaged in larger
than single servings.
(3)
Additional back
up meals may be authorized at the discretion of the Ohio department of medicaid
(ODM), the Ohio department of aging (ODA), or their designee.
(C)
Meals
will not be:
(1)
Processed, pre-packed and commercially available to the
general public for purchase; or
(2)
Provided in order
to supplant or replace the purchase of food or groceries for
others.
(D)
Provider qualifications.
(1)
A provider of
home delivered meals will maintain evidence of:
(a)
A current, valid
food operations or other applicable license or certificate as required by
licensing or regulatory agencies where the meal is produced.
(b)
Good standing
with all applicable federal, state and local regulatory agencies;
and
(c)
Meeting applicable licensing requirements for safety,
storage, sanitation and other applicable provisions for food
service.
(2)
The provider will develop, implement and maintain
evidence of a training plan that includes orientation and annual continuing
education.
(a)
The provider will ensure anyone who participates in meal
preparation, handling or delivery receives orientation on topics relevant to
the person's job duties before they perform those duties.
(b)
The provider will
ensure anyone who participates in meal preparation, handling or delivery
completes continuing education annually on topics relevant to the person's job
duties.
(E)
Delivery
requirements.
(1)
Delivery will be based on a routine delivery date and
range of time.
(2)
The provider will notify the individual if meal
delivery will be delayed or will not occur as planned.
(3)
The provider will
ensure that delivery provided by commercial or common carrier meets applicable
federal, state and local food safety, storage and sanitation
requirements.
(F)
The provider will maintain the following
documentation:
(1)
Initial and subsequent person-centered services plans
for each individual;
(2)
All diet orders;
(3)
Documentation of
meal delivery, including:
(a)
The individual's name;
(b)
The date, time
and number of meals in the delivery;
(c)
Verification of
delivery in accordance with the individual's person-centered services
plan;
(d)
Verification that the individual was notified if
service delivery was not provided within the established delivery date or time;
and
(e)
Verification that the individual has been furnished
clear instructions about how to safely heat, reheat and assemble each
meal.
(4)
A written record, including date and topics covered,
during the completion of orientation and continuing education
sessions;
(5)
All licensure or certification documents required by
this rule;
(6)
All local licensing or regulatory agency inspection
reports and documented findings, any resulting plans of correction and any
follow up reports; and
(7)
All United States department of agriculture inspection
reports and documented findings, any resulting plans of correction and any
follow-up reports.
(G)
The provider will
replace any item lost or stolen between the time of delivery and non-receipt by
the individual at no cost to the individual, ODM, ODA, or their
designee.
Notes
Promulgated Under: 119.03
Statutory Authority: 5166.02
Rule Amplifies: 5162.03, 5166.02, 5164.02
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