CMS Pub. 100-11, ch. 6, § 50.2

Except when a participant has a problem and must receive substitute foods or nutritional

supplements or needs nutrition support (as discussed below) the PACE organization must

ensure, through the assessment and care planning process that each participant receives

nourishing, palatable, well-balanced meals that meet the participant’s daily

nutritional/medical and special dietary needs. Meals should be procured, prepared and

provided by appropriately trained/certified/experienced food service staff (i.e., qualified

by training/certification in food safety and sanitation). Each meal must meet the

following requirements:

• Be prepared by methods that conserve nutritive value, flavor, and appearance;

• Be prepared in a form designed to meet individual needs; and

• Be prepared and served at the proper temperature.

The PACE organization must provide substitute foods or nutrition supplements that meet

the daily nutritional and special dietary needs of any participant who has any of the

following problems:

• Refuses the food served;

• Cannot tolerate the food served;

• Does not consume adequate calories and nutrients appropriate in meeting the

individual’s estimated nutritional needs determined at the initial and interim

assessments.

The PACE organization must provide nutrition support to meet the daily nutritional needs

of a participant, if indicated by his or her medical condition or diagnosis. Nutrition

support consists of tube feedings, total parenteral nutrition, or peripheral parenteral

nutrition.

[42 CFR §§ 460.64(a)(1), 460.78(a)]