This letter provides guidance and procedures for nursing homes and other healthcare facilities to ensure meals and snacks are served at times that meet the needs and preferences of residents. The letter defines a nourishing snack as items from the basic food groups, either singly or in combination with each other, and suitable and nourishing alternative meals and snacks as meals of similar nutritive value as the meal or snack offered at the normally scheduled time and consistent with the resident plan of care. Facilities must observe meal times and schedules, determine if they are offered at regular times comparable to normal times found in the community, and interview residents to get their input. They must provide suitable and nourishing alternative meals and snacks for residents who want to eat at non-traditional times or outside of scheduled meal times. Facilities must also ensure that snacks are available for residents upon request. Nursing homes and other healthcare facilities must take these actions to ensure that meals and snacks are served at times that meet the needs and preferences of residents.

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