Actually, the dining standards are not so new! The Pioneer Network is a growing coalition of organizations and individuals from across the nation, dedicated to making fundamental changes in values and practices in long term care. In 2011, the task force met to review and redefine dining practice standards with a focus on improving quality of life for the elderly in nursing home settings. The result was a comprehensive study with recommendations titled “New Dining Practice Standards.” The goal statement: “Establish nationally agreed upon new standards of practice supporting individualized care and self-directed living versus traditional diagnosis-focused treatment.” Among the programs supporters are the American Occupational Therapy Association, the American Speech-Language-Hearing Association, the American Dietetic Association and the American Association of Nurse Assessment Coordination.

Specific focus was given to CMS Tag F280 (Was interdisciplinary input provided by the care plan team to improve the resident’s functional abilities?) Examples:

• Did an occupational therapist assess the need for adaptive equipment or did a speech therapist provide techniques to improve swallowing ability?
• Do the dietitian and the SLP work together to determine optimum textures and consistencies for the resident’s food that is both nutritionally adequate and safe to swallow?
• Is there evidence of physician involvement?

The basic tenant of this new standard is that caregivers determine diet content, textures and consistencies collaboratively with the resident/POA and in consideration of his/her informed choices, goals and preferences, rather than by diagnosis. It is important for professionals caring for the elderly in long term care settings to respect and abide by the wishes of those in their care. By encouraging creative care plan design for meal times, nutritional intake, and choices of the resident, we significantly improve quality of life and satisfaction.

The Centers for Medicare and Medicaid Services (CMS) has issued a new Survey and Certification Letter announcing the Pioneer Network/CMS New Dining Practice Standards and an accompanying training video available to both surveyors and the public.