You know the adage, if you do not like the weather wait a few minutes and it will change. The same seems to be true of the updated nutrition guidelines coming from CMS! In CMS memo QSSAM-26-03 Hospital/CAH, CMS is reminding hospital providers of their obligations related to resident food and nutrition services. In fairness, this has not hit post-acute care YET but buckle up, I am sure it is not far off!

So, what do the new guidelines include? Well, at the end of the day, the recommendations focus on eliminating or limiting ultra-processed foods, sugar-sweetened beverages, refined carbohydrates, and added sugars. The emphasis should instead be on vegetables, fruits, legumes, nuts, seeds, seafood, healthy fats, and preparation methods such as baking, broiling, roasting, stir-frying, or grilling while eliminating deep-fried cooking methods. The guidelines also recommend eliminating processed meats and providing meals with less than 10 grams of added sugar.

CMS outlined these updated nutrition expectations in QSSAM-26-03 Hospital/CAH, detailing new recommendations related to food preparation methods, processed foods, and sugar limitations.

That is all well and good and they even provided a sample diet example:

• Steel-cut oats with berries and nuts instead of refined cereal with added sugar. There go the Cheerios.
• Plain yogurt with fresh fruit instead of flavored yogurt with added sugars. Let me know how that goes over with your residents.
• Grilled salmon with quinoa and roasted vegetables. Not sure I would like the aroma.
• Lentil or bean-based entrées with leafy greens and olive oil vinaigrette. I do not know a senior who would enjoy lentils or beans for dinner.
• Replacement of processed deli meats with freshly prepared lean protein options. So, no more bologna sandwiches with mayo?
• Beverage options include water, unsweetened tea, milk, or coffee while avoiding sugar-sweetened beverages or juice. Sorry, these residents grew up on orange juice every morning!

Okay, off my soap box but seriously? I hope that when these updated nutrition guidelines eventually make their way into post-acute care, everyone involved remembers the importance of resident-centered care. You can provide all the great nutritious foods you can afford and still have residents experiencing weight loss and dissatisfaction with meals.

McKnight’s Long-Term Care News recently discussed how these proposed nutrition changes could eventually affect nursing homes and long-term care providers.

The only advice I can give at this point is to take it slowly. It might be helpful to introduce juices with lower sugar, mix fresh fruit into yogurt before serving, try fresh turkey sandwiches instead of bologna, and, sorry, no advice on the salmon!

Stay well and stay informed!