In addition to the 6 feet spacing guidance, handwashing and the use of masks, what other things should be considered when opening up for communal dining?



On April 6, 2021, AHCA/NCAL provided a summary of the CMS guidance with the following recommendations for consideration:

  1. Identify residents who are high-risk for choking and who may cough and create droplets. These residents should be spaced at least six (6) feet or more from others in the dining area, and staff should take appropriate precautions with the necessary PPE (masks, gloves, eye protection and gowns) given the risk for these residents to cough while eating.
  2. Residents who require assistance with feeding should be spaced apart as much as possible, six (6) feet or more if possible, or no more than one person per table.  Staff members should strictly adhere to hand hygiene when assisting more than one resident at a time and must perform hand hygiene with at least hand sanitizer every time they switch assistance between residents.
  3. Consider increasing the number of meal services or offer meals in shifts to allow fewer residents in the common dining areas at one time.


Additional recommendations for operating if there are limited resources:

  1. Consider enlisting the help of all staff (as appropriate) to assist with meal service. While some may not be able to assist residents who may have special needs with eating, they can assist in getting the meals to the residents.
  2. Check to make sure there are adequate supplies for meals, including dishes, flatware, carts etc. to provide meal service to all residents and meet infection control guidelines. When transporting meals to residents, the food and carts need to be appropriately covered to protect from contamination.
  3. Facilities may need to adjust menus to offer choice while also managing their staffing efficiently.
  4. Paper products for use with selective menus and meal services should be handled in a way to minimize contact across staff and residents.


Blog by Janine Lehman, RN, RAC-CT, CLNC, Proactive Medical Review

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