Nutrition & Foodservice Edge Magazine - September/October 2023 - 21

REFERENCES
Scan QR code to view the list
of resources for this article.
DEFINITIONS YOU SHOULD KNOW
It is important to know the definitions used in
State Operations Manual Appendix Q, which
include:
* Likely/Likelihood means the nature and/or
extent of the identified noncompliance creates
reasonable expectation that an adverse outcome
resulting in serious injury, harm, impairment, or
death will occur if not corrected.
* Noncompliance means failure to meet one
or more federal health, safety, and/or quality
regulations.
* Psychosocial refers to the combined influence of
psychological factors and the surrounding social
environment on physical, emotional, and/or
mental wellness.
* Recipient is a person (patient, resident, or
client) who receives care and/or services from
a Medicare and/or Medicaid participating
provider/supplier, or a patient or individual
served by a laboratory subject to CLIA.
* Recipient at Risk is a recipient who, as a result
of noncompliance, and in consideration of the
recipient's physical, mental, psychosocial or
health needs, and/or vulnerabilities, is likely to
experience a serious adverse outcome.
* Removal Plan/Immediate Action includes
all actions the entity has taken or will take to
immediately address the noncompliance that
resulted in or made serious injury, serious harm,
serious impairment, or death likely.
* Serious injury, serious harm, serious
impairment, or death are adverse outcomes
which result in, or are likely to result in:
> death;
> a significant decline in physical, mental, or
psychosocial functioning (that is not solely due
to the normal progression of a disease or aging
process); or
> loss of limb, or disfigurement; or
> avoidable pain that is excruciating, and more
than transient; or
> other serious harm that creates lifethreatening
complications/conditions.
* Substantial Compliance is:
> One or more standard-level deficiencies with
an acceptable Plan of Correction (PoC); or
> A deficiency cited at severity Level One for
SNFs or NFs (i.e., Scope and Severity A, B, or
C) with an acceptable PoC for B and C level
deficiencies.
F803
Menus and nutritional adequacy: Examples of Level 4,
immediate jeopardy to resident health and safety include
but are not limited to:
* The facility only maintains a one day supply of foods and
drink on hand to prepare and serve their planned menus.
This supply did not include foods to meet the nutritional
needs or choices of residents. Several residents reported
that they were often hungry and were told by staff that no
snacks or other food was available.
* Facility staff failed to follow a menu for a resident on a
puree diet. The wrong texture of diet was provided which
resulted in a choking incident for this resident. This placed
the resident at risk for potential death or brain damage
due to lack of oxygen from choking.
F812
Food safety requirements: Examples of Level 4, immediate
jeopardy to resident health and safety include but are not
limited to:
* A 10-quart covered stock pot with 8 quarts of cooked beans
was in the refrigerator. The internal temperature of the
beans at the time of survey was measured at 68 degrees
F. The cook stated these beans had been cooked the day
NUTRITION & F OOD SER VICE EDGE | SEPTEMBER-OCTOBER 2023 21
https://www.anfponline.org/news-resources/nutrition-and-foodservice-magazine/qr-code-landing-pages/september-october-2023
Nutrition & Foodservice Edge Magazine - September/October 2023

Table of Contents for the Digital Edition of Nutrition & Foodservice Edge Magazine - September/October 2023
