OAR 333-520-0020: Dietary Services

(1) All hospitals, regardless of classification, shall comply with this rule. (2) A hospital shall: (a) Have an organized dietary department, directed by qualified personnel, that conforms to the requirements in OAR 333-150-0000, the Food Sanitation Rules. (b) Employ supportive personnel competent to carry out the functions of the dietary service, including a full-time director with overall supervisory responsibility for the dietary service and who is: (A) A qualified dietitian who is registered by the Commission on Dietetic Registration of the Academy of Nutrition and Dietetics; (B) A person who has received a baccalaureate or higher degree with major studies in food, nutrition, diet therapy or food service management and has at least one year of supervisory experience in a health care dietetic service, and participates in continuing education related to the dietetic profession; (C) A graduate of a dietetic technician or dietetic assistant training program, corresponding or classroom, approved by the Academy of Nutrition and Dietetics; (D) A graduate of a state approved course that provides 90 or more hours of classroom instruction in food service supervision and has one year's experience as a supervisor in a health care institution; or (E) Has training and experience in food service supervision and management in a military service equivalent in content to one of the above criteria for qualifying. (c) Contract with a dietician with the qualifications listed in paragraph (2)(b)(A) of this rule, if the Director is not a qualified dietitian under paragraph (2)(b)(A) of this rule, and: (A) Consult at least quarterly with the contractor; (B) Have on file a contract signed by the consultant and the hospital administrator stating the relationship of the consultant to the hospital, services to be provided, length of contract, terms and hours; and (C) Require the contractor to submit quarterly reports to the hospital administrator and the committee, council or other reviewing body designated by the hospital as having responsibility for dietary services that include: (i) The date(s) of visit(s) and length of time spent on premises; (ii) Staff members seen; (iii) Services performed; (iv) Action taken on previous reports; (v) Problems identified; and (vi) Recommended action and distribution of the report. (d) Require the on-site visits of the Consulting Dietitian to be of sufficient duration and frequency to review dietetic systems and assure quality food to the patient. (e) Provide dietetic services to patients in accordance with a written order by the responsible physician, or other health care practitioner authorized within the scope of his or her professional license, and record appropriate dietetic information in the patient's medical record including the following: (A) Timely and periodic assessments of the patient's nutrient intake and tolerance to the prescribed diet modification, including the effect of the patient's appetite and food habits on food intake; (B) A description of the diet instructions given to the patient or family and assessment of their diet knowledge; (C) A description or copy of the diet information forwarded to another institution upon patient discharge; and (D) Nutritional care follow-up with the patient’s health care practitioner or a health care agency. (f) Regularly review and evaluate the quality and appropriateness of nutritional care provided by the dietetic service including the nutritional adequacy of all menus. (g) Ensure that the Dietetic Service is represented on hospital committees concerned with nutritional care. (h) Serve food that has an appetizing appearance, is palatable, is served at proper temperature and is cooked and served in such a way as to retain the nutrient value of food. (i) Restrict admittance to the kitchen area to those who must enter to perform assigned duties. (j) Develop written procedures for cleaning equipment and work areas and enforce those procedures.