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?
  • Completing the Review
  • Deciding to Review Later
• 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 or texture 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?
  • Why does a resident/patient now have NPO as their diet? I cannot remove NPO as the diet order for a resident/patient.
  • How do I print a report of residents/patients with a specific diet type or texture type? For example, I want to see all my "lactose controlled" residents?
  • What people report prints a tally for each assigned diet and texture?
  • What people report prints a list of assigned diet types and texture types?
  • 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 a resident/patient has personal menu customizations, and you change their diet order, the Review Customizations window appears (screenshot below) for you to review. 

Depending on the customization, it will either continue to be active for the new diet order or it is placed on hold for you to review and determine if you will set it as active for the new diet order. 

• On-hold customizations are listed on the left in the On Hold - Needs Review column. 
• Active customizations are listed on the right in the Active column. 

*If a personal menu item, specific substitute, fallback substitute, or serving size adjustment was added to the personal menu as a result of assigning a diet intervention, then those customizations are automatically applied instead of being held for review. 

Completing the Review

For an on-hold customization that you want to set as active for the new diet order, click its Set as Active button. The customization is moved to the right side of the window in the Active column. 

For an active customization that you want to place on hold for the new diet order, click its Place On-Hold button. The customization is moved to the left side of the window in the On Hold -Needs Review column. 

When you are satisfied with the review (i.e., the current on-hold customizations and the current active customizations for the diet order), then click the Complete Review button to continue to the personal menu screen for the resident/patient. 

Deciding to Review Later

If you cannot review the customizations at the moment, then the review can always be done later; therefore click the Decide Later button. Upon doing so, the Review Customizations message appears (screenshot below) stating that customizations on hold will remain on hold, and each time you open the profile the Review Customizations window will appear again for you to review. You can also review the customizations from the personal menu (click here for instructions).

When customizations are still on-hold, then the following occurs:

• On the People Listing screen, the Review Needed label appears in the Alerts column. 
  
  
   
• When opening the resident/patient profile, the Review Customizations window appears (screenshot below) again for you to finish your review. 
  
   
• On the resident/patient profile slide-out panel that appears when you open their profile, the Review Needed label appears at the top beside the Go to Personal Menu link. 
  
  
   
• When the personal menu is open for the resident/patient profile, the Manage Customizations button also has the Review Needed label. 
  
  
   
• When clicking the Manage Customizations button, the Manage Customizations slide-out panel appears listing the active customizations and displaying a banner at top stating that review is needed because there are customizations still on-hold (first screenshot below). The banner includes the Review Customization link that opens the Review Customization window (second screenshot below) for you finish your review. 
  
  
  

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 regular menu 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 your Connect interface setting of When a person is readmitted 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. 

Possible Reason 3:

Check the Connect interface diet order mapping to ensure that an EHR diet order is not mistakenly mapped to NPO. If so, remap the diet order as necessary. 

How do I print a report of residents/patients with a specific diet type or texture type? For example, I want to see all my "lactose controlled" residents?

Use the People Listing screen. From the screen, open the filters and select the desired diet type, texture type, fluid type, and click Apply. Residents/patients with the selected types appear onscreen. You can then click the Export button to generate an Excel® file of those residents/patients. 

Note: The filters operate as AND filters, meaning only residents/patients with the selected combination are returned. For example, for the Diet filter if you only select Heart Healthy, and for the Texture filter you only select Puree, then resident/patients with that combination are returned. 

What people report prints a tally for each assigned diet and texture?

Unfortunately no specific report exists. However, you can use the People Listing screen, and filter the screen by Diet and Texture filters to see the tally for a diet/texture combination. You can then click the Export button to generate an Excel® file of those residents/patients. 

Note: The filters operate as AND filters, meaning only residents/patients with the selected combination are returned. For example, for the Diet filter if you only select Heart Healthy, and for the Texture filter you only select Puree, then resident/patients with that combination are returned. 

What people report prints a list of assigned diet types and texture types?

You can use the People Listing screen, and filter the residents/patients returned onscreen by the Diet and Texture filters. You can then click the Export button to generate an Excel® file of those residents/patients. 

Note: The filters operate as AND filters, meaning only residents/patients with the selected combination are returned. For example, for the Diet filter if you only select Heart Healthy, and for the Texture filter you only select Puree, then resident/patients with that combination are returned. 

Alternatively, you can 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. 

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).