F-803: Menus That Meet the Mark—It’s More Than a Meal Plan

Smart Bites: LTC Nutrition Insights

Issue No. 7 — December 9, 2025

F-803: Menus That Meet the Mark—It’s More Than a Meal Plan

Your posted menus are more than a courtesy—they’re a legal and clinical promise to provide residents with meals that meet nutritional requirements, physician orders, and personal preferences.

F-803 requires that menus are:

  • Written and followed

  • Nutritionally adequate

  • Accommodating to special needs

  • And most importantly—actually served as planned or with appropriate substitutions

This tag is often cited when surveyors spot inconsistencies between the posted menu, production sheets, and what lands on the plate.

 

What Does F-803 Require?

Facilities must:

  • Develop menus in accordance with RD-approved nutritional standards

  • Follow menus as planned, including texture modifications

  • Provide substitutions that are equal in nutritional value when needed

  • Maintain supporting documentation for menu planning and changes

 

Common Survey Triggers for F-803:

  • Meals served do not match the posted menu (e.g., rice served instead of pasta with no substitution documentation)

  • Substitutes offered are not of similar nutritional value

  • RD has not reviewed or approved the menu cycle

  • Menus don’t reflect seasonal changes or resident preferences

 

Smart Tips for F-803 Compliance:

  1. Audit for Menu Accuracy Weekly
    Check that production, tray tickets, and actual meals align with the posted menu. Spot-check trays at random across units.

  2. Maintain Documentation for Substitutions
    Log what was substituted and why—ran out of item, preference, etc.—and ensure the alternative is nutritionally comparable.

  3. Keep RD Approval on File
    Your Registered Dietitian must review and sign off on menus and substitutions. Include documentation of nutrient analysis or meal planning software reports.

  4. Integrate Preferences into Menu Planning
    Regularly review preference sheets and resident council feedback when updating menu cycles.

  5. Adapt for Seasons and Supply Chain Changes
    If you’re making a seasonal or permanent swap (e.g., fresh berries to canned), update the written menu accordingly—not just the production sheets.

 

Did You Know?
If your menu doesn’t match what’s served—or if your substitutions aren’t documented—surveyors will cite F-803, even if the food is well-liked.

 

Stay Ahead with Smart Bites
Next issue: F-804 – Nutritive Value and Personalized Diets
Need help auditing menus, training staff, or creating compliant substitutions? Contact info@dietarysolutions.net or visit www.dietarysolutions.net.

Amanda Smith