F-806: Therapeutic Diets – When Nutrition Becomes a Clinical Compliance Risk
Smart Bites: LTC Nutrition Insights
Issue No. 4 — September 9, 2025
F-806: Therapeutic Diets – When Nutrition Becomes a Clinical Compliance Risk
The F-806 tag centers on ensuring that residents receive and consume the therapeutic diets prescribed by a physician—a tag that bridges the dietary department and the clinical team.
What makes F-806 tricky? It’s not just about serving the right tray—it’s about:
The right order
The right documentation
The right interdisciplinary follow-through
And if any part is missing? It’s a deficiency.
What Does F-806 Require?
Facilities must:
Provide therapeutic diets as ordered by the physician.
Ensure that the appropriate staff review, monitor, and update these diets, based on resident status.
Collaborate across disciplines—physician, RD, nursing, and food services—to implement and adjust diets appropriately.
Common Survey Triggers for F-806:
Resident receiving the wrong diet texture or type (e.g., regular instead of mechanical soft).
Lack of a current therapeutic diet order in the medical record.
Diet order discontinued or changed without a clinical rationale.
Poor intake noted, but no adjustment to the plan of care or diet.
Smart Tips for F-806 Compliance:
Tie Diet Orders to Care Plans
Ensure that staff charts every therapeutic diet in the resident’s care plan—and reviews it at every significant change.Audit Tray Accuracy Weekly
Use a sample of residents with special diets. Check if tray cards, production sheets, and served trays align with the charted orders.Establish RD/MD Communication Protocols
When the dietitian recommends a change, how is it communicated and documented? Standardize this pathway to ensure timely updates.Train Staff on Diet Types and Purpose
CNAs and dietary aides should understand the reasons behind a resident's puree or low-sodium diet, particularly when residents resist or request alternatives.Document Clinical Rationale
If a resident refuses a diet or is allowed a liberalized diet for quality of life, the interdisciplinary team must document that decision.
Did You Know?
CMS instructs surveyors to observe meal service and interview residents receiving therapeutic diets to ensure staff meet the residents’ preferences, effectiveness, and clinical outcomes.. Don’t let a missed conversation lead to a missed citation.
Stay Ahead with Smart Bites
Coming soon: Issue No. 5 will spotlight F-801 – Staffing Requirements for Food and Nutrition Services.
Have questions about dietary documentation or therapeutic diets? Reach out at info@dietarysolutions.net or visit www.dietarysolutions.net.