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Donna Manring

The revised F-Tags are now in place. How is your organization meeting compliance for survey? Do they understand the complexity of the revised guidelines for F-Tag 325 and F371? Could you still be in the danger zone? IT CAN HAPPEN. As you are aware, some of the old tags have been revised by CMS. Do you know what the hot buttons are for surveyors? Trained surveyors know what deficiencies to look for in nutrition care and sanitation. IT CAN HAPPEN. Sanitation violations continue to be the most common violation. Weight loss and weight gain continue to be a focus. Is your dining program meeting OBRA standards? Is your dining program in compliance, promoting a home-like atmosphere?

Regulations F325 and F371 were designed to dramatically increase nutritional parameters for residents and ensure safe sanitation systems. As nutrition and food service professionals, we know there are many factors that influence outcomes. The new guidelines for nutrition require that the resident maintains, to the greatest extent possible, acceptable nutritional status and that the facility provide nutritional care and services to each resident consistent with their comprehensive assessment. With enhanced dining programs, some residents may have unplanned weight gain which could have significant health implications. The scope of interventions necessary to meet residents' nutritional needs depends on many factors, including but not limited to:

  • A resident's current food intake.
  • The degree of nutritional impairment or risk.
  • Resident choices.
  • The response to initial interventions.
  • The feasibility of addressing underlying conditions and causes for weight changes.

Staff can optimize a resident's nutritional status by using a systematic approach which includes identifying and assessing each resident's nutritional status and risk factors, evaluating/analyzing the assessment information, developing and consistently implementing pertinent approaches, and monitoring the effectiveness of interventions and revising them as necessary.

Be informed. This is not just a dietary department focus. Facilities must identify key individuals to participate in the assessment of nutritional status and related causes and consequences. Effective food safety systems involve identifying hazards at specific points during food handling, preparation, serving and identifying how the hazards can be prevented, reduced or eliminated. It is important to focus attention on the risks associated with food-borne illnesses by identifying critical control points (CCPs) in the food preparation processes that, if not controlled, might result in food safety hazards.

Organizations need to develop operational steps critical to the control, prevention or elimination of food safety hazards. The key for survey success is education, training, and monitoring of all staff and volunteers involved in food service and handling. They need to establish effective infection control and quality assurance programs to help maintain safe practices and identify potential food handling problems/risks associated with systems and staff.

Great information... now how do you begin accomplishing these goals? Maun-Lemke Senior Consultant, Donna Manring, has extensive experience nationwide in working with organizations to diagnose and resolve dietary issues by developing systems and implementing action plans to assure regulatory compliance. As a former Director of Dining Services and Clinical Nutrition, she understands the internal issues associated with employee empowerment and their importance to survey success.

Donna will facilitate, review and recommend improvements to assure compliance in both regulatory and survey protocol expectations. She can provide training for all departments involved with the dining experience. She can assist your organization by conducting a "Mock Survey" and direct staff on how to best respond to the survey process. She'll develop systems that will prepare facilities for each survey including what each department needs to know.


At the completion of this program, the participants will be able to:

  1. Evaluate, address, and provide optimal nutritional care and service to meet the needs of all residents in compliance with F-Tag 325.

  2. Become "Survey Ready" by developing and implementing an action plan that includes standards of practice documentation and proactive outcomes to assure regulatory compliance.

  3. Identify critical control points (CCPs) in the food preparation process and implement systems to assure compliance in both regulatory and survey protocol.

  4. Prevent your facility from falling victim to a facility wide food-borne illness case.

This program uses PowerPoint, lecture, handouts, discussion and question/answer.

Related Article: Revised Surveyor Guidance for Nutrition & Sanitary Conditions: What They Mean & How You Can Remain Compliant

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