In order to help the public compare nursing homes for their loved ones, the Centers for Medicare & Medicaid Services developed the Five-Star Quality Rating System. This system is based on health inspections, staffing and quality measures. Many times, the focus starts and stays on the clinical and nursing side. However, if healthcare communities are not taking a closer look at their dining and nutritional programs, they may be missing simple components in a key area that could help them achieve the five-star rating they need and deserve.
Some areas to start looking at within your dining and nutritional programs include:
Health Inspections:
Not only will the kitchen require a walk through, but the dining room will also be observed during meal times. It is important to ensure your entire team and not just your dietary staff knows and understands food safety in the dining room and kitchen. Make sure you have educational resources and signage in key areas to help your team know when and how to wash hands as well as when to glove when helping out. Also, work with your dietitian to ensure you are not only meeting nutritional requirements with your menu but also providing preferences and meeting ethnic needs.
Quality Measure – Percentage of High-Risk Residents with Pressure Ulcers (Sores):
Work with your dietitian and nursing team to look at supplements as a way to assist with treating and preventing sores, asking questions like – "Are residents on supplements? Are they eating/drinking them? When are they given supplements?" Focusing on person-centered care by asking your seniors what they like. With all of the options available now, they no longer have to choose between only strawberry, chocolate and vanilla milkshakes.
Quality Measure – Percentage of Residents with a UTI:
Work with your whole team to focus on hydration as a way to combat UTIs. Assist by providing foods high in water content. Brainstorm with your team to think about the the variety of ways dehydration occurs. Do your reasons involve decreased thirst perception, inability to obtain fluids, intentionally decreasing intake to prevent episodes of incontinence, dysphagia, communication barriers, etc.?
Quality Measure – Percentage of Residents Experiencing One or More Falls with Major Injury:
Work with your team to look at hydration as a way to combat falls. Also consider looking at lab work and asking questions such as – "Was hemoglobin low, and if so… did that cause weakness? Is the resident anemic? Does he/she have postprandial hypotension? Has there been weight loss?"
By taking a closer look at your dining room and your nutritional programs, you may find many areas to ensure greater success with the newly implemented Five-Star Quality Rating System. Spend time in your dining room, and observe what is going on. Are there areas for your team, even outside of dietary, to be educated? Observing and asking questions are two of the best things that you can do to create a five-star experience for your residents.
