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RD Office
Long Term Care Forms
| Resource | Description | Download |
|---|---|---|
| Audit Dining Services | In-depth dining services/kitchen audit | Log In or Subscribe |
| Care Plan Diabetes Mellitus | General care plan for diabetes mellitus | Log In or Subscribe |
| Care Plan Fluid Restriction | General care plan for fluid restriction | Log In or Subscribe |
| Care Plan Weight Gain | General care plan for weight gain with behavioral health | Log In or Subscribe |
| Care Plan Weight Loss | General care plan for weight loss w behavior health | Log In or Subscribe |
| Dishmachine ppm Record | Log In or Subscribe | |
| Dishmachine Temperature Record | Log In or Subscribe | |
| Documentation Report | Log In or Subscribe | |
| Fluid Restriction Worksheet | Log In or Subscribe | |
| Food Preference | Form to use when questioning elders about their food preferences. | Log In or Subscribe |
| Food Temperature, Final Cook & Steam Table | Log In or Subscribe | |
| Food Temperature, Steam Table & Test Tray | Log In or Subscribe | |
| Freezer Temperature w Reporting | Freezer temps, time, and non-compliant HACCP reporting | Log In or Subscribe |
| In-Service Training | A documentation form for in-service training. | Log In or Subscribe |
| Menu Substitution | Keep track of substitutions your staff makes to the planned menu. | Log In or Subscribe |
| Nutrition Assessment, In-Depth | Log In or Subscribe | |
| Nutrition Care – Tube Feeding Assessment | Log In or Subscribe | |
| Nutrition Care Follow-Up for TF | Monthly/Quarterly Tube Feeding Assessment Follow-up | Log In or Subscribe |
| Pot Sink ppm Record | Log In or Subscribe | |
| Progress Note | Log In or Subscribe | |
| Quarterly Nutrition Progress | Quarterly nutrition note for the diet tech/dietary manager | Log In or Subscribe |
| Rapid Cooling Record | Log In or Subscribe | |
| RD Referral List | Log In or Subscribe | |
| Refrigerator Temperature Record | Log In or Subscribe | |
| Refrigerator Temperature w Reporting | Includes temps, time, and non-compliance HACCP reporting | Log In or Subscribe |
| Resident Food Complaint | Keep track of resident food complaints and what was done to fix them. | Log In or Subscribe |
| Sack Lunch Temperature Record | Use this form to monitor and record the temperature of sack lunches once they leave the building. | Log In or Subscribe |
| Sanitation Bucket Record ppm | Log In or Subscribe | |
| Thermometer Calibration | Log In or Subscribe |
Policy & Procedures
| Resource | Description | Download |
|---|---|---|
| Abnormal Lab | Log In or Subscribe | |
| Adaptive Eating Device | Log In or Subscribe | |
| Bench Can Opener | Cleaning Procedure | Log In or Subscribe |
| Blender | Cleaning Procedure | Log In or Subscribe |
| Bread Service | Log In or Subscribe | |
| Broken Dish Disposal | Log In or Subscribe | |
| Burn Prevention | Log In or Subscribe | |
| Calorie Count | Log In or Subscribe | |
| Canned Food Storage | Log In or Subscribe | |
| Cardex | Log In or Subscribe | |
| Care Plan | Log In or Subscribe | |
| Chemical Safety | Log In or Subscribe | |
| Cleaning Procedures | Cleaning Procedure | Log In or Subscribe |
| Cleaning Schedule | Cleaning Procedure | Log In or Subscribe |
| Coffee Temperature | Log In or Subscribe | |
| Coffee Urn | Log In or Subscribe | |
| Cold Food Storage | Log In or Subscribe | |
| Comfort Food | Log In or Subscribe | |
| Comfort Nutrition & Hydration | Log In or Subscribe | |
| Cutting Board | Log In or Subscribe | |
| Diet Compliance & Resident Rights | Log In or Subscribe | |
| Diet Liberalization | Log In or Subscribe | |
| Diet Manual | Log In or Subscribe | |
| Diet Order | Log In or Subscribe | |
| Dietitian Consultant | Log In or Subscribe | |
| Dietitian Recommendation Follow-up | Log In or Subscribe | |
| Dietitian Referral & Recommendations | Log In or Subscribe | |
| Dietitian Referral Tube Feeding Fax | Log In or Subscribe | |
| Dish-room Sanitation | Log In or Subscribe | |
| Dishwashing | Log In or Subscribe | |
| Disposable Gloves | Log In or Subscribe | |
| Disruption of Gas or Electricity | Log In or Subscribe | |
| Double Portion | Log In or Subscribe | |
| Egg Handling | Log In or Subscribe | |
| Emergency Meal Preparation | Log In or Subscribe | |
| Emergency Planning | Log In or Subscribe | |
| Employee Beverage | Log In or Subscribe | |
| End of Life | Log In or Subscribe | |
| Enteral Feedings | Log In or Subscribe | |
| Enteral Nutrition Therapy | Log In or Subscribe | |
| Equipment Safety | Log In or Subscribe | |
| Equipment Sanitizing | Log In or Subscribe | |
| Final Cook Temperature | Log In or Subscribe | |
| Fire Prevention | Log In or Subscribe | |
| First In, First Out | Log In or Subscribe | |
| Floor Safety | Log In or Subscribe | |
| Floor- Broom Sweeping | Cleaning Procedure | Log In or Subscribe |
| Floor- Wet Mopping | Cleaning Procedure | Log In or Subscribe |
| Fluid Restriction | Log In or Subscribe | |
| Food & Fluid Intake | Log In or Subscribe | |
| Food Contact Surfaces Cleaning & Sanitizing | Log In or Subscribe | |
| Food Fortification & Supplementation | Log In or Subscribe | |
| Food Grinder & Food Chopper | Cleaning Procedure | Log In or Subscribe |
| Food Handling Nursing Medication Pass | Log In or Subscribe | |
| Food Intake Records | Log In or Subscribe | |
| Food Mixer | Cleaning Procedure | Log In or Subscribe |
| Food Service Sanitation Manager Training | Log In or Subscribe | |
| Food Slicer | Cleaning Procedure | Log In or Subscribe |
| Food Temperature | Log In or Subscribe | |
| Food Temperature Resident Service | Log In or Subscribe | |
| Formulary Standardization | Log In or Subscribe | |
| Garbage Cans & Lids | Cleaning Procedure | Log In or Subscribe |
| Garbage Disposal | Log In or Subscribe | |
| Griddle | Cleaning Procedure | Log In or Subscribe |
| Hand Washing | Log In or Subscribe | |
| Handling Clean Dishwares | Log In or Subscribe | |
| Handling Fresh Fruits & Vegetables | Log In or Subscribe | |
| Height Measurement | Log In or Subscribe | |
| Hood | Cleaning Procedure | Log In or Subscribe |
| Hood Filter | Cleaning Procedure | Log In or Subscribe |
| Hot Weather Menu | Log In or Subscribe | |
| House Supplement | Log In or Subscribe | |
| Hydration & Thickened Liquids | Log In or Subscribe | |
| Hydration at Risk | Log In or Subscribe | |
| Ice | Log In or Subscribe | |
| Ice Machine | Cleaning Procedure | Log In or Subscribe |
| In-depth Nutrition Assessment | Log In or Subscribe | |
| In-Service Training | Log In or Subscribe | |
| Ingredient Bins | Cleaning Procedure | Log In or Subscribe |
| Job Description | Log In or Subscribe | |
| Job Description Dining Services Aide | Log In or Subscribe | |
| Job Description Dining Services Cook | Log In or Subscribe | |
| Job Description Dining Services Manager | Log In or Subscribe | |
| Job Procedure | Log In or Subscribe | |
| Job Procedure Sample- Cook | Log In or Subscribe | |
| Knife Safety | Log In or Subscribe | |
| Labeling & Dating | Log In or Subscribe | |
| Leftover Food | Log In or Subscribe | |
| Meal Assembly Food Delivery Safety | Log In or Subscribe | |
| Meal of the Month | Log In or Subscribe | |
| Meal Service | Log In or Subscribe | |
| Mechanical Soft Preparation | Log In or Subscribe | |
| Mechanical Washing Sanitation Testing | Log In or Subscribe | |
| Med Pass Program | Log In or Subscribe | |
| Medication Side Effect | Log In or Subscribe | |
| Menu & Nutrition Adequacy | Log In or Subscribe | |
| Menu Alternate Service | Log In or Subscribe | |
| Menu Changes | Log In or Subscribe | |
| Microwave Cooking | Log In or Subscribe | |
| Milk Intolerance | Log In or Subscribe | |
| Modified Consistency Preparation | Log In or Subscribe | |
| Monthly Weights | Log In or Subscribe | |
| New Resident Interview | Log In or Subscribe | |
| Non-Dining Services Personnel | Log In or Subscribe | |
| Nursing Unit Food Safety | Log In or Subscribe | |
| Nutrition at Risk | Log In or Subscribe | |
| Nutrition at Risk Worksheet | Log In or Subscribe | |
| Order of Meals Served | Log In or Subscribe | |
| Orientation | Log In or Subscribe | |
| Oven | Cleaning Procedure | Log In or Subscribe |
| Personal Hygiene | Log In or Subscribe | |
| Picnics & Outdoor Eating Events | Log In or Subscribe | |
| Pleasure Eating | Log In or Subscribe | |
| Poor Intake Action Plan | Log In or Subscribe | |
| Pot & Pan Washing | Log In or Subscribe | |
| Pressure Ulcer Documentation | Log In or Subscribe | |
| Pressure Ulcer Interventions | Log In or Subscribe | |
| Pressure Ulcer Interventions | TM Mgt - The RD and IDT may amend interventions based on the individualized needs of the resident. 10/2/12 | Log In or Subscribe |
| Puree Food Prep | Log In or Subscribe | |
| Range | Cleaning Procedure | Log In or Subscribe |
| Rapid Cooling of Food | Log In or Subscribe | |
| Receiving & Handling | Log In or Subscribe | |
| Refrigerator-Freezer | Cleaning Procedure | Log In or Subscribe |
| Resident Choice | Log In or Subscribe | |
| Resident Meal Assembly | Log In or Subscribe | |
| Resident Personal Food | Log In or Subscribe | |
| Resident Refrigerator | Log In or Subscribe | |
| Rotary Toaster | Cleaning Procedure | Log In or Subscribe |
| Sack Lunch Transportation | Log In or Subscribe | |
| Sack Lunches | Log In or Subscribe | |
| Safe Food Preparation | Log In or Subscribe | |
| Salt Substitute | Log In or Subscribe | |
| Sanitizing Solutions | Log In or Subscribe | |
| Second Helpings | Useful policy for behavior health (TMM) | Log In or Subscribe |
| Serving Meals | Log In or Subscribe | |
| Snacks | Log In or Subscribe | |
| Snacks, Nutritious | Log In or Subscribe | |
| Standard Diets | Log In or Subscribe | |
| Steam Table | Cleaning Procedure | Log In or Subscribe |
| Storage of Dry Foods & Supplies | Log In or Subscribe | |
| Storage Safety | Log In or Subscribe | |
| Sufficient Staff | Log In or Subscribe | |
| Swallow Therapy | Log In or Subscribe | |
| Temperature of Room Trays | Log In or Subscribe | |
| Test Tray | Log In or Subscribe | |
| Thawing Food | Log In or Subscribe | |
| Thickened Soup | Log In or Subscribe | |
| Tray Cards and/or Menus | Cleaning Procedure | Log In or Subscribe |
| Tray Carts | Cleaning Procedure | Log In or Subscribe |
| Utility Carts | Cleaning Procedure | Log In or Subscribe |
| Visitor Procured Foods | Log In or Subscribe | |
| Wait Staff Clean Hands | Log In or Subscribe | |
| Waiver of Treatment | Log In or Subscribe | |
| Weekly Weights | Log In or Subscribe | |
| Weighing | Log In or Subscribe | |
| Weight Loss Intervention | Log In or Subscribe |
In-Services
| Resource | Description | Download |
|---|---|---|
| Boil Water Order | Competency Quiz | Log In or Subscribe |
| Diet Liberalization | Competency Quiz | Log In or Subscribe |
| Glove Use | Competency Quiz | Log In or Subscribe |
| Hand Washing | Competency Quiz | Log In or Subscribe |
| Height Measurement | Describes 3 ways to measure resident height. Competency quiz. | Log In or Subscribe |
| Portion Control | Competency Quiz | Log In or Subscribe |
| Rapid Cooling | Competency Quiz | Log In or Subscribe |
| Tips for Preventing Food Borne Illness | Competency Quiz | Log In or Subscribe |
| Use of a Thermometer | Competency Quiz | Log In or Subscribe |
Compliance Posters
| Resource | Description | Download |
|---|---|---|
| Critical Temperature | Log In or Subscribe | |
| Diet Liberalization Nurse’s Station Chart | Log In or Subscribe | |
| Disposable Gloves | Log In or Subscribe | |
| First Aid for Burns | Log In or Subscribe | |
| Protein Equivalents | Log In or Subscribe | |
| Rapid Cooling | Log In or Subscribe | |
| Resident Planned Alternates | Log In or Subscribe | |
| Three Compartment Sink | Log In or Subscribe |
Educational Videos
Nutrition Education
| Resource | Description | Download |
|---|---|---|
| Added Sugars | Ways to reduce added sugar in your diet. | Log In or Subscribe |
| Advanced Diabetes | Normal blood sugar levels. Diabetes and diet. | Log In or Subscribe |
| Antioxidants | Antioxidants support anti-aging | Log In or Subscribe |
| Basic Diabetes | How to recognize diabetes symptoms and managing diabetes. | Log In or Subscribe |
| Food Drug Interactions | Food and Drug interactions | Log In or Subscribe |
| Foods Ok for Renal Diet | List of foods that are ok when you are on a renal diet. | Log In or Subscribe |
| Healthy Holiday Eating | Eating healthy during the Holidays | Log In or Subscribe |
| Heart Healthy | How to keep your heart healthy | Log In or Subscribe |
| Hidden Phosphorus in Foods | Look for hidden phosphorus in foods you eat | Log In or Subscribe |
| Know about Potassium | Know about Potassium - Make the right choice | Log In or Subscribe |
| Phosphate Binders | Understanding Phosphate Binders | Log In or Subscribe |
| Phosphorus | Foods containing phosphorus | Log In or Subscribe |
| Potassium | All About Potassium | Log In or Subscribe |
| Protein | Protein and how it relates to dialysis | Log In or Subscribe |
| Shopping and Dining Out Guidelines | Shopping and Dining Out while you are on dialysis | Log In or Subscribe |
| Sodium and Blood Pressure | Eating to lower blood pressure | Log In or Subscribe |
| Sodium and Fluid | All about Sodium and Fluid | Log In or Subscribe |
| Strong and Healthy Bones | Diet and joint health | Log In or Subscribe |
| Water Wisdom | Why fluids are important. | Log In or Subscribe |
| Who Needs Fiber | The importance of fiber in your diet. | Log In or Subscribe |
Desk Review (Podcasts)
| Resource | Description | Download |
|---|---|---|
| Dietitian Communication | This form can be used for written communication with others members of the health care team, e.g. SLP | Log In or Subscribe |
| Facility List for On Call Dietitians | Facilities we service for on call faxes | Log In or Subscribe |
| Fax Cover Sheet TF | Cover sheet for returning completed TF fax assessment. | Log In or Subscribe |
| Fax Referral | Log In or Subscribe | |
| Internal Report | Log In or Subscribe | |
| Kitchen Food Observation | Mini audit to be completed quarterly. | Log In or Subscribe |
| LRA Dietitian Report | Log In or Subscribe | |
| Mary Litchford handouts | Laboratory Assessment of Nutritional Status: Bridging Theory & Practice Inflammation & Metabolic Meltdown | Log In or Subscribe |
| Mary Litchford Powerpoint presentation | Laboratory Assessment of Nutritional Status: Bridging Theory & Practice Inflammation & Metabolic Meltdown | Log In or Subscribe |
| NKF – Sodium | National Kidney Foundation, Sodium, tips for people with chronic kidney disease (CKD) | Log In or Subscribe |
| NKF- Phosphorus | National Kidney Foundation Phosphorus - tips for people with chronic kidney disease (CKD) | Log In or Subscribe |
| NKF- Spanish- Potassium | National Kidney Foundation, Spanish Potassium, tips for people with chronic kidney patients (CKD) | Log In or Subscribe |
| NKF- Spanish-Phosphorus | Natiional Kidney Foundation, Spanish Phosphorus, tips for people with chronic kidney patients (CKD) | Log In or Subscribe |
| NKF- Your test results | National Kidney Foundation, understanding your kidney test results | Log In or Subscribe |
| NKF-Food Label | How to read a food label- tips for people with Chronic Kidney Disease | Log In or Subscribe |
| NKF-Potassium | National Kidney Foundation - Potassium, tips for people with chronic kidney disease (CKD) | Log In or Subscribe |
| NKF-Protein | National Kidney Foundation - Protein, tips for people with chronic kidney disease (CKD) | Log In or Subscribe |
| NKF-Spanish-Food Label | Natiional Kidney Foundation, Spanish Food Label, understanding food labels for people with chronic kidney patients (CKD) | Log In or Subscribe |
| NKF-Spanish-Protein | Natiional Kidney Foundation, Spanish Protein, tips for people with chronic kidney patients (CKD) | Log In or Subscribe |
| NKF-Spanish-Sodium | Natiional Kidney Foundation, Spanish Sodium, tips for people with chronic kidney patients (CKD) | Log In or Subscribe |
| Nutrition Hydration TF Status | Mini audit to be completed quarterly. | Log In or Subscribe |
| RD Recommendation | Log In or Subscribe | |
| Resident Interview & Observation | Mini audit to be completed quarterly. | Log In or Subscribe |
| TF Fax Referral | Fax referral for tube feed only - May use for CCHS homes; Prairie, Tri-State, Beecher, etc | Log In or Subscribe |