A battered three-ring binder located near the dining room holds a form, one for each resident. On each piece of paper is a printed grid designed for the documentation of percent food consumed at breakfast, lunch, and dinner. A variation of this form can be found in almost every nursing home in the US. It is the Food Intake Record.
A few years ago one of my clients had such a bad survey the state health department assigned a Monitor to the building. The purpose of the Monitor was to assist and guide the facility toward regulatory compliance. The State identified a deficiency in the facility’s ability to identify residents with poor oral fluid and food intake.
In an effort to find the solution I developed a magnificent Food & Fluid Intake Record. The intake record was so thorough it would put every other Food Intake Record to shame. It was the Food Intake Record to end all Food Intake Records!
The Monitor took one look at my perfect Food Intake Record and said, “This form is setting the facility up for failure. This is like completing a calorie count on each person at each meal.” She explained the nursing home must have a system in place to identify individuals that are eating poorly or consuming less than normal so staff can identify the cause and begin interventions as needed. Traditional food intake records, although commonly used, are not required. This is probably a good thing since many of the Food Intake Records I’ve seen have been completed in advance, at the end of the month, and on occasion – daily.
Since that time I have recommended my clients adopt a food intake system that identifies residents eating poorly or less than normal. The Food Intake Record consists of a tray ticket and a bucket. Aides place the tray ticket of poor eaters in the bucket. The Dining Services Manager or designee collects the tickets and follows-up with the resident. Some of my clients hold fast to the three-ring binder. For them I recommend a form that identifies only those residents eating poorly or less than normal. The Dining Services Manager or designee needs to review the binder daily.
No matter what system your nursing home uses ensure the staff is well trained and residents eating poorly get the interventions they need.