Hawaii Administrative Rules › Title 11 - DEPARTMENT OF HEALTH › Subtitle 1 - GENERAL DEPARTMENTAL PROVISIONS › Chapter 100.1 - ADULT RESIDENTIAL CARE HOMES › Subchapter 2 - TYPE I ARCH › Section 11-100.1-13 - Nutrition

Current through June, 2024
(a) The Type I ARCH shall provide each
				  resident with an appetizing, nourishing, well-balanced diet that meets the
				  daily nutritional needs and diet order prescribed by state and national dietary
				  guidelines. To promote a social environment, residents, primary care givers and
				  the primary care giver's family members residing in the Type I ARCH shall be
				  encouraged to sit together at meal times. The same quality of foods provided to
				  the "primary care givers and their family members shall be made available to
				  the residents unless contraindicated by the resident's physician or APRN,
				  resident's preference or resident's family.
(b) Menus shall be written at least one week
				  in advance, revised periodically, dated, and followed. If cycle menus are used,
				  there shall be a minimum of four weekly menus.
(c) Menus shall accommodate residents' food
				  preferences, cultural and ethnic backgrounds and habits as much as possible,
				  provided nutritional quality is maintained.
(d) Current menus shall be posted in the
				  kitchen and in a conspicuous place in the dining area for the residents and
				  department to review.
(e)
				  Substitutes offered to residents who refuse food served shall be of similar
				  nutritive value and documented.
(f)
				  A minimum of three meals shall be provided at regular intervals in each twenty
				  four hour period. There shall be no more than fourteen hours between a
				  substantial evening meal and breakfast.
(g) There shall be on the premises a minimum
				  of three days' food supply, adequate to serve the number of individuals who
				  reside at the ARCH or expanded ARCH.
(h) The kitchen and food supply shall be
				  accessible to residents who may desire snacks between meals, as
				  appropriate.
(i) Each resident
				  shall have a documented diet order on admission and readmission to the Type I
				  ARCH and shall have the documented diet annually signed by the resident's
				  physician or APRN. Verbal orders for diets shall be recorded on the physician
				  order sheet and written confirmation by the attending physician or APRN shall
				  be obtained during the next office visit.
(j) Each resident shall be provided with
				  sufficient fluids to ensure adequate hydration.
(k) Physician or APRN orders for nutritional
				  supplements including vitamins, minerals, formula meals and thickening agents
				  shall be updated annually or sooner as specified.
(l) Special diets shall be provided for
				  residents only as ordered by their physician or APRN. Only those Type I ARCHs
				  licensed to provide special diets may admit residents requiring such
				  diets.
(m) A business entity
				  operating more than one Type I ARCH, shall utilize a registered dietitian to
				  assist in the planning of menus and provide special 'diet consultation, as
				  needed. The consultant shall provide special diet training to food preparation
				  staff to ensure competency.