As many administrators of ALFs are aware, the culinary program can be the bane of your existence. Food quality or they lack thereof is one of the most common complaints from residents and families. The dietary program is a difficult arena because you are balancing so many different things. There is the health code for restaurants, resident’s personal food preferences and the operational aspect of providing those meals. While the facility may not be considered a ‘4-star Michelin restaurant’ you can rest assured following the following regulations, provided by the Arizona Bureau of Residential Facilities Licensing, will keep you in the clear for any potential issues with state surveyors:
R9-10-817. Food Services
- A manager shall ensure that:
- A food menu:
- Is prepared at least one week in advance,
- Includes the foods to be served each day,
- Is conspicuously posted at least one calendar day before the first meal on the food menu is served,
- Includes any food substitution no later than the morning of the day of meal service with a food substitution, and
- Is maintained for at least 60 calendar days after the last day included in the food menu;
- Meals and snacks provided by the assisted living facility are served according to posted menus;
- If the assisted living facility contracts with a food establishment, as established in 9 A.A.C. 8, Article 1, to prepare and deliver food to the assisted living facility, a copy of the food establishment’s license or permit under 9 A.A.C. 8, Article 1 is maintained by the assisted living facility;
- The assisted living facility is able to store, refrigerate, and reheat food to meet the dietary needs of a resident;
- Meals and snacks for each day are planned using the applicable guidelines in http://www.health.gov/dietaryguidelines/2015;
- A resident is provided a diet that meets the resident’s nutritional needs as specified in the resident’s service plan;
- Water is available and accessible to residents at all times unless otherwise stated in a medical practitioner’s order; and
- A resident requiring assistance to eat is provided with assistance that recognizes the resident’s nutritional, physical, and social needs, including the provision of adaptive eating equipment or utensils, such as a plate guard, rocking fork, or assistive hand device, if not provided by the resident.
- If the assisted living facility offers therapeutic diets, a manager shall ensure that:
- A current therapeutic diet manual is available for use by employees, and
- The therapeutic diet is provided to a resident according to a written order from the resident’s primary care provider or another medical practitioner.
- A manager shall ensure that food is obtained, prepared, served, and stored as follows:
- Food is free from spoilage, filth, or other contamination and is safe for human consumption;
- Food is protected from potential contamination;
- Food is prepared: a. Using methods that conserve nutritional value, flavor, and appearance; and b. In a form to meet the needs of a resident, such as cut, chopped, ground, pureed, or thickened;
- Potentially hazardous food is maintained as follows:
- Foods requiring refrigeration are maintained at 41° F or below; and
- Foods requiring cooking are cooked to heat all parts of the food to a temperature of at least 145° F for 15 seconds, except that:
- Ground beef and ground meats are cooked to heat all parts of the food to at least 155° F;
- Poultry, poultry stuffing, stuffed meats, and stuffing that contains meat are cooked to heat all parts of the food to at least 165° F;
iii. Pork and any food containing pork are cooked to heat all parts of the food to at least 155° F;
- Raw shell eggs for immediate consumption are cooked to at least 145° F for 15 seconds and any food containing raw shell eggs is cooked to heat all parts of the food to at least 155 °F;
- Roast beef and beefsteak are cooked to an internal temperature of at least 155° F; and vi. Leftovers are reheated to a temperature of at least 165° F;
- A refrigerator used by an assisted living facility to store food or medication contains a thermometer, accurate to plus or minus 3° F, placed at the warmest part of the refrigerator;
- Frozen foods are stored at a temperature of 0° F or below; and
- Tableware, utensils, equipment, and food-contact surfaces are clean and in good repair.
- A manager of an assisted living center shall ensure that:
- The assisted living center has a license or permits as a food establishment under 9 A.A.C. 8, Article 1; and
- A copy of the assisted living center’s food establishment license or permit is maintained.
Top Takeaways:
- A food menu:
- Is prepared at least one week in advance,
- Includes the foods to be served each day,
- Is conspicuously posted at least one calendar day before the first meal on the food menu is served,
- Includes any food substitution no later than the morning of the day of meal service with a food substitution, and
- Is maintained for at least 60 calendar days after the last day included in the food menu;
State inspectors will certainly review your food menus to ensure you are meeting the requirements listed above. It would be wise to have a system in place for the filing of previous food menus.
- A manager shall ensure that food is obtained, prepared, served, and stored as follows: 1-7
This reg is one that is required to meet the standard of both the Bureau of Residential Facilities Licensing as well as the department of health. Pretty standard stuff, but it deals with health safety due to the potential issues of spoilage and cross contamination of raw food products.
Pro Tip:
- Ensure your dietary team is well versed in sanitation, cross contamination, and general food handling procedures. Rest assured they will be quizzed by the survey team.
- Ask your residents what they would like to see on the menu. This will drastically improve the satisfaction of your food service program if residents are giving input into their food choices.