Currently, the Centers for Medicare & Medicaid Services (CMS) has extensive regulations in place to promote and support healthy foods and nutrition in nursing homes. Interpretative guidance discusses requirements for food safety, procurement, handling, and foodborne illnesses. For example, CMS reminds facilities that food must meet safe and sanitary conditions related to when, where, and how food is received for consumption. This could be restrictive for items such as raw milk or unpasteurized eggs. Community leaders also report having difficulty finding local vendors who can provide fresh fruits and vegetables and comply with these restrictions. Careful menu planning can help ensure that foods are used prior to expiration dates, there is a process for tracking these dates, and expired products are disposed of appropriately. 

The food and nutrition services team should have plans in place for what will happen if power goes down or food preparation and/or service is disrupted due to a natural disaster or other issue. This should include a process for maintaining and using nonperishable products, such as canned goods. 

As the Trump administration pursues its Make America Healthy Again agenda, the long term care profession is encouraging regulators to offer reasonable flexibilities while still upholding safety. “It’s important that when considering healthy food offerings in nursing homes, the residents’ food preferences are still at the core of decision-making,” said Holly Harmon, RN, BSN, MBA, LNHA, FACHCA, and senior vice president of Quality, Regulatory, and Clinical Services at the American Health Care Association. “Honoring resident choice and cultural differences as it relates to food preferences is crucial in maintaining person-centered care. Regulators can achieve this through supportive communication that emphasizes flexibilities for nursing homes and encourages creative approaches that promote quality of life for the residents they serve.” ​