This letter outlines the requirements for nursing homes and other healthcare facilities to develop menus that meet the nutritional, religious, cultural, and ethnic needs of their residents. It also outlines the guidance, procedures, and probes that should be taken to ensure that menus are updated periodically and are reviewed by a qualified nutrition professional. Facilities are expected to make reasonable efforts to provide food that is appetizing to and culturally appropriate for their residents, and to make reasonable and good faith efforts to develop a menu based on resident requests and resident groups' feedback. If a resident's dietary intake appears inadequate, facility staff should document the steps taken to learn what their preferences are. Nursing homes and other healthcare facilities should take these requirements and guidance into account in order to ensure the nutritional and cultural needs of their residents are met.

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