Assigning Diet Order (Diet Type, Texture Type) to a Resident/Patient

• About Assigning Diet Orders
• Manually Assigning a Diet Type
• Manually Assigning Multiple Diet Types (for Informational Purposes Only and US Accounts Only) 
• Manually Assigning a Texture Type
  • Why is a Diet Type or Texture Type not Available for Selection?
• Manually Assigning Different Texture Types
• What Happens When you Change Diet Order of Person with Personal Menu Customizations?
  • If Diet Order Had Not Been Assigned Before
  • If Diet Order Had Been Assigned Before
• What Happens When you Change Diet Order of Person with an Assigned Diet Intervention?
• How to Assign a Temporary Diet Order to a Resident/Patient
• FAQs
  • Resident/patient is on a therapeutic diet order (i.e., diet type/texture type combination), but is allowed a regular item that is outside the therapeutic diet order, or another item from another therapeutic diet order?
  • Resident/patient is on a regular diet order (i.e., regular diet type and texture type), but requires a therapeutic recipe (non-regular diet type and/or texture type)?
  • How do I change the name of a diet type? How do I change the name of a texture type?
  • A diet type, texture type, fluid type that I assign to a resident/patient does not save (i.e., reverts back or changes automatically).
  • I have a resident with the vegetarian diet type, but who consumes fish? How can I set it up so that the resident is served fish?
  • I cannot remove NPO as the diet order for a resident/patient.
  • What report prints a list of residents with a specific diet type, texture type or fluid type? For example, I want to see all my lactose free residents?
  • Is there a way to assign nutritional risk to a resident/patient?

About Assigning Diet Orders

When you assign a diet type and texture type to a resident/patient, the system will automatically serve the therapeutic substitute item that is extended for a menu item via its menu item extension grid. 

This article explains how to manually assign diet orders (diet type, texture type) to residents/patients in your MealSuite account. Manually assigning diet orders will be necessary if your account is not utilizing a MealSuite Connect interface to automatically pull in diet order assignments from your EHR. 

Note: If your account utilizes a Connect interface to pull in diet order assignments from your EHR, then any diet orders that you manually assign on people profiles will subsequently be overwritten by the Connect interface when it syncs data from the EHR. 

Manually Assigning a Diet Type

From the Diets field in the Personal Information section of the person’s profile, you can assign a diet type to a person. 

Manually Assigning Multiple Diet Types (for Informational Purposes Only and US Accounts Only)

If you are a US account, there may be the ability to assign multiple diet types to a resident/patient profile for informational purposes. For example, Diabetic/Renal/Vegetarian. A resident with multiple diet types will be listed on the various people reports that print diet orders. 

Warning: The assignment of multiple diet types to a resident/patient profile is for informational purposes only, and is only available to US accounts. If a profile is assigned multiple diet types, then only the primary diet type is used by the system to control what foods are served on the personal menu. Additional diet types (i.e., secondary and tertiary diet types) DO NOT CONTROL what foods are served on a resident's personal menu. 

If your US account does have the ability to assign multiple diet types to a resident/patient profile, there will be the Assign Multiple Diets link below the Diets drop-down on the resident/patient profile screen (screenshot below). This link can be enabled or disabled as needed for your US account; to do so see Enabling/Disabling the Ability to Assign Multiple Diet Types (for Information Purposes Only) to a Profile


Assuming your US account is enabled to assign multiple diet types (for informational purposes only), then complete the following steps to do so:

1. From below the Diets field in the Personal Information section, click the Assign Multiple Diets link to display the Multiple Diets Assignment window. 
   
   
   
    

2. From the right column, select the diet types to assign. 

   
   
    

3. From the left column, you can sort the diet type priority by dragging and dropping a diet type to the desired spot in the list. 
   
   
    

4. You remove a diet type by clicking its icon. 

   
   
    

5. Click Save at the top right of the panel to apply your changes.

Manually Assigning a Texture Type

From the Texture field in the Personal Information section of the person’s profile, you assign a texture type to a person.  

Why is a Diet Type or Texture Type not Available for Selection? 

If a diet type or texture type is grey and not available for selection, it indicates that the specific diet type/texture type combination is unpublished in the system (see Unpublishing or Publishing a Diet Type/Texture Type Combination for more information). For example, assume the following diet type/texture type combination is unpublished:

• Diet type: Fat Restricted
• Texture type: Easy to Chew

On a person's profile, the combination will not be available for selection. Either the diet type or texture type can be selected, but its combination counterpart will be greyed out and not available for selection. 

Manually Assigning Different Texture Types

To accommodate the increased acuity of a resident/patient during the day, MealSuite allows a person to be assigned different texture types for different meal periods/snack times. For example, assume regular texture foods for a resident can be had at breakfast and lunch, but later in the day as the resident becomes more tired (and therefore at risk for an incident) the texture is downgraded to be mince meat for dinner and soft and bite-sized for snack HS.

To assign different texture types for different meal periods/snack times:

1. From below the Texture field in the Personal Information section, click the Assign Texture by Meal link. The Assigning Texture by Meal window appears.
   
   

   

    
2. Select the desired textures for each meal period/snack time.

3. Click Apply to apply your changes. When a person is assigned different texture types, the Texture field displays Multiple Selected, and the different texture types for the meal periods/snack times are listed below the field.
    

   
   
    
4. Click Save at the top right of the panel to apply your changes.

What Happens When you Change Diet Order of Person with Personal Menu Customizations?

If Diet Order Had Not Been Assigned Before

If a person is set up with personal menu customizations, and you subsequently change their diet order (either the diet type or texture type), and the new diet order had not been previously assigned to that person before, or had been assigned before but does not have any customizations, then you are given the opportunity to copy personal menu customizations from any previous diet orders to the current diet order via the Copy Customizations window: 

• If all customizations from the last-assigned diet order are applicable to the current diet order, click the Copy Selected Customizations to Current Diet Order button.
   
• If all customizations from the last-assigned diet order are not applicable to the current diet order, select the Do Not Copy, Items Are Not Applicable button. Note that if you choose this option, then you are not prevented in the future from returning to the profile and copying customizations from any past diet order to the current diet order. To do so, see Copying Customizations of Past Diet Orders to Current Diet Order.
   
• If only some customizations from the last-assigned diet order are applicable to the current diet order, then clear the check boxes of those non-applicable customizations, and then click the Copy Selected Customizations to Current Diet Order to copy the customizations.
  
  
   
• If customizations from other previously-assigned diet orders are applicable, then do the following:
  1. From the Past Diet Orders column on the left, select the past diet order from which you want to copy its customizations. The customizations of the selected diet order appear on the right. 
  2. From the customizations list on the right, clear or select the check boxes of the customizations you want to copy. 
  3. Click the Copy Selected Customizations to Current Diet Order. The customizations from the resident's past diet order are copied to the resident's current diet order. 
     
     

If Diet Order Had Been Assigned Before

If a person is set up with personal menu customizations, and you subsequently change their diet order (either the diet type or texture type), and that new diet order had been previously assigned before with customizations, then the customizations of that previously-assigned diet order are restored. 

The Review Personal Menu Customization window appears to inform you of such, and also informs you to review these restored customizations to ensure they still apply. The window also gives you the opportunity to copy personal menu customizations from other former diet orders to the currently-assigned diet order. 

Depending on your desired course of action, complete one of the following steps:

• If the customizations of the current diet order do not need changes, click the Do Not Copy, Items Are Not Applicable button. 
   
• If the customizations of the current diet order do need changes, then this is done via the person's personal menu. Therefore, first close the window by clicking the Do Not Copy, Items Are Not Applicable button, and then work on the personal menu customizations as needed; articles to do so are in the following chapter: Personal Menus. 
   
• From the Review Personal Menu Customizations window, you do have opportunity to copy customizations from previously-assigned diet orders to the current diet order. To do so:
  1. From the Past Diet Orders column on the left, select the past diet order from which you want to copy its customizations. The customizations of the selected diet order appear on the right. 
  2. From the customizations list on the right, clear or select the check boxes of the customizations you want to copy. 
  3. Click the Copy Selected Customizations to Current Diet Order. The customizations from the resident's past diet order are copied to the resident's current diet order. 

What Happens When you Change Diet Order of Person with an Assigned Diet Intervention?

If a person’s diet order (i.e., diet type and texture type) is changed, and that new diet order is not valid for any of their assigned diet interventions (i.e., the diet type/texture type of the intervention does not match the diet type/texture of the person), a message appears stating that the intervention will be removed from the profile along with its personal menu customizations.

How to Assign a Temporary Diet Order to a Resident/Patient

There is no specific feature to assign a temporary diet order to a resident/patient. However, there is the following workaround that can be done: 

1. Create a diet intervention consisting of the diet type and texture type that is to be assigned to the profile.
   1. Name the diet intervention Temporary Diet Order.
   2. Do not assign any customizations to the diet intervention. 
       
2. Assign the person the diet type and texture type required for their temporary diet order (see Assigning Diet Order to Person).
   
   
    
3. Assign the person the Temporary Diet Order diet intervention (see Assigning a Diet Intervention).
   
   
    
4. In the Client ID field, enter the end date of the temporary diet order. 
   
   
    
5. When you click the Save button to save the profile, a message appears stating that the intervention has no customizations, and functions as a note on the profile only. This is as expected; click OK to this message.
   
   
    
6. On the People listing screen, set the columns to display Diet Interventions and Client ID, which you can see from the screenshot below has the effect of indicating that a profile has a temporary diet order with end date. To set columns, see Setting Preferred Columns on the People Listing Screen.
   
   

With the above workaround, any diet order updates in the EHR and received from your Connect interface will not automatically remove or overwrite the manually-added intervention or client ID, ensuring better control and accuracy in managing temporary diet orders. 

FAQs

Resident/patient is on a therapeutic diet order (i.e., diet type/texture type combination), but is allowed a regular item that is outside the therapeutic diet order, or another item from another therapeutic diet order?

For example, the patient is on the regular diet type and minced & moist texture type, but bread is allowed. Another example is the patient is on a lactose restricted diet, but can tolerate certain dairy foods like yogurt.

You have the following options:

• Use a specific substitute to replace the original item with the desired item. When you replace an item with a specific substitute, the specific substitute replaces the original item in all instances the original item exists.
• Add a personal menu item, using the Instead of Menu Item option, to replace the original item. When adding a personal menu item to replace an original item, the original item is only replaced for the specific day, meal service, and menu category that you select when adding the personal menu item (as opposed to replacing all instances the original item exists).

It is also recommended to leave a profile note on the resident profile stating that they can consume the item outside their assigned diet order. 

Possible Reason 1:

This typically means the following scenario has occurred:

1. The resident/patient had an LOA, and your EHR system processed the LOA as a discharge, which triggers the Connect interface to the EHR to archive the profile in your MealSuite account.
2. When the resident was readmitted, the Connect interface received an Admit message for the profile, and the Connect setting in your account for an Admit message is to assign the default diet order, which is often NPO, as that is the lowest risk option for safety reasons. 
3. The resident/patient in the EHR is not assigned an active diet order, and as such their profile in your MealSuite account is not updated and therefore will continue to be NPO.

Because your account is using a Connect interface to pull in diet order assignments from your EHR, manually assigning their diet order in your MealSuite account will not be permanent. You instead must assign diet orders in your EHR. The Connect interface will then perform a synch to update the diet order in your MealSuite account.

Possible Reason 2:

If you have a Connect interface with PointClickCare (PCC), it could be that the diet order was put on hold. If the diet order is put on hold in PCC, then the Diet, Texture and Fluid fields will populate with NPO. When the on hold status is removed from the diet order in PCC, then the Connect update process will return the previously-assigned diet order to the MealSuite resident/patient profile. 

You can confirm if a diet order is on hold for a resident/patient profile by clicking their PointClickCare tab and scrolling to the Diet Order section, where the status is listed. 

What report prints a list of residents with a specific diet type, texture type or fluid type? For example, I want to see all my lactose free residents?

You an use the People Roster report, which prints a list of residents with a column each for diet, texture, and fluid type (screenshot below). The report can be sorted by diet order, which first sorts by diet type, then sub-sorts by texture type, then sub-sorts by fluid type, then sub-sorts by last name. 

Alternatively, you can open the People Listing screen, and sort by either the Diets, Textures, and Fluid columns, and then export the people list to an Excel® file, from which you can make further edits to remove any information you do not need. 

Is there a way to assign nutritional risk to a resident/patient?

The system does not have a means to enter nutritional risk for a profile. However, a workaround is to enter the nutritional risk level in the Client ID field for the profile (see Opening a Resident/Patient Profile).