Nutritional services in a skilled nursing facility cover meal planning, therapeutic diets, and intake monitoring to match a resident’s diet to their medical needs.
Sadie G. Mays Health & Rehabilitation Center is a nonprofit that has run its 206-bed skilled nursing facility in northwest Atlanta since 1947.
At the center, a registered dietitian plans the menus and a staff chef directs meal preparation.
Residents receive three meals and two snacks daily, with each resident’s dietary plan recorded in the care plan.
Hospital discharge leaves little time to sort out special diets. The Sadie G. Mays admissions team reviews a parent’s diet orders before move-in at 678-420-2946.
Sadie G. Mays provides nutrition screening, dietitian-planned menus, therapeutic and texture-modified diets, meal monitoring, and nutrition education. Five roles share that work, and each one handles a different step between a diet order and the meal tray.
Team Member | Role in a Resident’s Nutrition |
Attending physician | Prescribes therapeutic diets and any nutrient supplements; may delegate diet prescribing to a registered or licensed dietitian where Georgia law allows |
Registered dietitian | Plans the Sadie G. Mays menus and checks them for nutritional adequacy |
Speech-language pathologist | Evaluates swallowing and recommends the food and liquid texture a resident should receive |
Dining department | Screens nutritional status at admission, completes routine assessments, tracks meal tolerance and satisfaction, checks tray accuracy, and teaches residents and families about diet orders |
Staff chef | Directs daily meal preparation |
Chauntelle Patterson High, Dietary Director and a member of the center’s leadership team, oversees the dining department and its daily operations.
Sadie G. Mays residents receive three meals and two snacks each day. Federal food and nutrition rules and Georgia’s nursing home dietary rules limit meal frequency and overnight gaps, and every Georgia nursing home schedule must meet them.
Scheduling Rule | Federal Standard (42 CFR 483.60(f)) | Georgia Standard (Rule 111-8-56-.06) |
Daily meals | At least 3 meals a day at times similar to ordinary community mealtimes | Meals served no more than 5 hours apart |
Evening meal to breakfast | No more than 14 hours; up to 16 hours with a nourishing bedtime snack and resident group agreement | No more than 14 hours |
Snacks and off-schedule eating | Healthy alternative meals and snacks for residents who prefer to eat outside set mealtimes | Between-meal and bedtime snacks offered to each resident |
Residents eat in a dining room updated through the $3.2 million renovation completed in 2025, one of the shared amenities on the northwest Atlanta campus.
The Sadie G. Mays dining department prepares therapeutic diets for residents with diabetes, heart conditions, and kidney disease, plus texture-modified meals for residents with chewing or swallowing problems. Every therapeutic diet starts with a written order from the attending physician.
Diets for Diabetes, Heart, and Kidney Conditions
Under 42 CFR 483.60(e), the attending physician prescribes each therapeutic diet and may delegate that task to a registered or licensed dietitian where Georgia law allows.
The dietitian turns the order into daily menus with set limits on carbohydrates, sodium, or fluids, so the kitchen serves the correct tray at every meal.
Texture-Modified Food and Thickened Liquids
A stroke, Parkinson’s disease, or advanced dementia can affect how safely a person swallows.
At Sadie G. Mays, speech therapy staff evaluate each resident’s swallowing and recommend a food and liquid texture, such as minced or pureed food or thickened liquids, based on that individual evaluation.
The kitchen prepares meals and drinks to the recommended level, and staff reviews the texture whenever the resident’s dietary plan is updated.
Cultural, Religious, and Personal Food Preferences
Federal menu rules direct nursing homes to make reasonable efforts to reflect residents’ religious, cultural, and ethnic food needs. The same rules require an option of similar nutritive value when a resident declines the meal served, and residents keep the right to make personal dietary choices.
Each resident’s diet at Sadie G. Mays moves through five steps, from the first screening to ongoing follow-up.
Nutrition supports rehabilitation and wound healing when calories, protein, and fluid match what the care team finds in each resident’s individual assessment.
At Sadie G. Mays, the dietary plan follows the resident’s rehabilitation and clinical goals and changes as those goals change.
Federal rule 42 CFR 483.25(g) requires nursing homes to help residents keep acceptable nutritional status, such as usual body weight and electrolyte balance, and to offer enough fluid to stay hydrated.
When a nutritional problem arises and the health care provider orders a therapeutic diet, the same rule requires the facility to offer it.
Sadie G. Mays includes nutritional management in its wound care services, including diet planning for residents with pressure injuries or other wounds.
Nutritional needs during healing differ from one resident to the next, so diet changes follow the individual assessment and any physician orders. Families can bring wound and diet questions to the first care plan meeting.
Dietary staff also work with physical, occupational, and speech therapists so calorie and protein targets fit each resident’s rehabilitation plan. Those targets come from the resident’s own assessment and shift when weight, lab values, or functional status change during the stay.
Weight loss after a hospital stay can stall recovery. Talk with admissions at Sadie G. Mays at 678-420-2946 about dietitian-planned meals and therapy coordination.
Federal and Georgia rules require every licensed Georgia nursing home to use a qualified dietitian, follow dietitian-reviewed menus, serve therapeutic diets only on written orders, handle food safely, and keep an emergency food supply on site.
Requirement | Federal Rule (42 CFR 483.60) | Georgia Rule (111-8-56) |
Dietitian qualifications | Bachelor’s or higher degree from an accredited nutrition or dietetics program, 900 hours of supervised practice, and state licensure or certification; in states without licensure, registration with the Commission on Dietetic Registration qualifies | Qualified dietitian with American Dietetic Association or equivalent qualifications (Rule .06) |
Dietitian time and food service director | Dietitian may be full-time, part-time, or a consultant; without a full-time dietitian, the facility names a food and nutrition services director who holds one of five listed qualifications (such as Certified Dietary Manager or certified food service manager), meets any state standards, and gets frequent dietitian consultations | At least 8 hours of dietitian services per month (Rule .06) |
Menus | Planned ahead, followed as written, refreshed from time to time, and checked by the dietitian for nutritional adequacy | Planned or approved by the dietitian, dated, and kept on file for 30 days (Rule .06) |
Diet orders | Therapeutic diets prescribed by the attending physician, with delegation to a dietitian where state law allows | Modified diets follow written orders from a physician or dentist; supplements only on written physician order (Rule .06) |
Feeding assistance | Paid feeding assistants finish a state-approved course, work under RN or LPN supervision, and help only residents the care team has assessed as having no complicated feeding problems, such as swallowing difficulty or tube feeding | Dining assistants work under an RN or LPN who is in the same room and available to respond (Rule .25), and they add to nursing staff without counting toward required nursing hours (Rule .04) |
Food safety and supply | Food from approved sources, stored and served under professional food safety standards | 24-hour supply of perishable food and 3-day supply of nonperishable food on site (Rule .06) |
Families can review a facility’s dietary inspection findings on CMS Care Compare, which posts survey results for every Medicare- and Medicaid-certified nursing home.
Original Medicare Part A covers meals and dietary counseling during a covered skilled nursing stay, so food is part of the daily care Medicare pays for during that stay.
Under Original Medicare, skilled nursing coverage generally requires a medically necessary inpatient hospital stay of at least 3 consecutive days, and time under observation or in the emergency room does not count toward those days.
A physician in an Accountable Care Organization with an approved Skilled Nursing Facility 3-Day Rule Waiver can remove that hospital-stay requirement, and Medicare Advantage plans may also waive it.
Part A covers up to 100 skilled nursing days in each benefit period, and coverage continues only while the resident needs daily skilled care, so it can end well before day 100. In 2026, days 1 to 20 cost $0 per day once the $1,736 Part A deductible is met, and a resident who already paid that deductible for a hospital stay in the same benefit period does not pay it again.
Days 21 to 100 carry $217 per day in coinsurance, and the resident pays all costs from day 101.
Medicare Advantage plans set their own cost sharing and may charge copayments during the first 20 days, so families confirm costs directly with the plan.
Long-term residents who no longer qualify for the Medicare skilled benefit usually pay for skilled nursing through Georgia Medicaid, long-term care insurance, or private funds.
Sadie G. Mays accepts Medicare, Medicaid, VA contract, managed care, private pay, and other insurance, and the admissions team confirms whether a specific plan is accepted.
Families get the clearest view of a nursing home’s dining program by asking who plans the menus, how diet orders reach the kitchen, and what staff do when a resident stops eating.
Visiting during lunch or dinner shows tray accuracy, the pace of staff help, and the feel of the dining room, details worth comparing alongside other nursing home tour questions about staffing and safety.
How can families raise a concern about a resident’s meals?
Families can raise meal concerns at care plan meetings, where the interdisciplinary team reviews the resident’s dietary plan, or by contacting the dining department between meetings. Sharing specific details, such as skipped meals, chewing trouble, or food dislikes, helps staff update the plan accurately.
Can a nursing home resident eat outside scheduled mealtimes?
Federal rule 42 CFR 483.60(f)(3) requires nursing homes to offer healthy alternative meals and snacks to residents who prefer to eat outside set mealtimes, in line with the care plan. Georgia Rule 111-8-56-.06 also requires staff to offer between-meal and bedtime snacks.
Who plans the menus in a Georgia nursing home?
A qualified dietitian plans or approves the menus in every Georgia nursing home under Rule 111-8-56-.06, which also requires at least 8 hours of dietitian services per month. Menus must be dated and kept on file for 30 days for physician and staff reference.
Can a nursing home serve a diabetic or low-sodium diet?
Nursing homes serve diabetic, low-sodium, renal, and other therapeutic diets when the attending physician prescribes them under 42 CFR 483.60(e). The physician may delegate diet prescribing to a registered or licensed dietitian where Georgia law allows, and the kitchen follows the written order.
What is a texture-modified diet?
A texture-modified diet is food prepared at a softer or smoother consistency, such as minced or pureed meals, sometimes with thickened liquids. A speech-language pathologist recommends the texture level after an individual swallowing evaluation, and the level can change as swallowing improves or declines.
Does Medicare pay for meals in a skilled nursing facility?
Original Medicare Part A covers meals and dietary counseling during a covered skilled nursing stay, which generally follows a 3-day inpatient hospital stay. In 2026, days 1 to 20 cost $0 per day once the deductible is met, and days 21 to 100 cost $217 per day.
Can families bring outside food to a nursing home resident?
Families can bring food to a nursing home resident, and 42 CFR 483.60(i) requires each facility to have a policy on storing and handling food from visitors. Families should share diet orders with staff before bringing anything for a resident on a therapeutic diet.
What happens when a nursing home resident stops eating or loses weight?
Under 42 CFR 483.25(g), a nursing home must help residents maintain acceptable nutritional status, such as usual body weight, and offer a therapeutic diet when a nutritional problem appears and the provider orders one. Dietary staff review intake, preferences, and alternatives with the care team.
Sadie G. Mays splits nutrition work among the attending physician, a registered dietitian, speech therapy, the dining department, and a staff chef, and records each dietary plan in the care plan.
Federal rule 42 CFR 483.60 and Georgia Rule 111-8-56-.06 set the dietitian, menu, and meal-timing standards behind that work. Original Medicare Part A covers meals during a covered skilled nursing stay, and families can review any facility’s dietary inspection record on CMS Care Compare.
A parent who has stopped eating well at home deserves a plan built around real needs. Contact the Sadie G. Mays admissions team at 678-420-2946.
