As many operators of ALFs are aware, the culinary program can be the bane of your existence. Food or lack thereof is one of the most common complaints from residents and families. While the facility may not be considered a ‘4-star Michelin restaurant’ you can rest assured following the following regulations, provided by the Texas Health and Human Services Commission, will keep you in the clear for any potential issues with state surveyors:
RULE 553.41 Standards for Type A and Type B Assisted Living Facilities
(m) Food and nutrition services.
(1) A person designated by the facility is responsible for the total foodservice of the facility.
(2) At least three meals or their equivalent must be served daily, at regular times, with no more than a 16-hour span between a substantial evening meal and breakfast the following morning. All exceptions must be specifically approved by DADS.
(3) Menus must be planned one week in advance and must be followed. Variations from the posted menus must be documented. Menus must be prepared to provide a balanced and nutritious diet, such as that recommended by the National Food and Nutrition Board. Food must be palatable and varied. Records of menus as served must be filed and maintained for 30 days after the date of serving.
(4) Therapeutic diets as ordered by the resident’s physician must be provided according to the service plan. Therapeutic diets that cannot customarily be prepared by a layperson must be calculated by a qualified dietician. Therapeutic diets that can customarily be prepared by a person in a family setting may be served by the assisted living facility.
(5) Supplies of staple foods for a minimum of a four-day period and perishable foods for a minimum of a one-day period must be maintained on the premises.
(6) Food must be obtained from sources that comply with all laws relating to food and food labeling. If food, subject to spoilage, is removed from its original container, it must be kept sealed and labeled. Food subject to spoilage must also be dated.
(7) Plastic containers with tight-fitting lids are acceptable for the storage of staple foods in the pantry.
(8) Potentially hazardous food, such as meat and milk products, must be stored at 45 degrees Fahrenheit or below. Hot food must be kept at 140 degrees Fahrenheit or above during preparation and serving. Food that is reheated must be heated to a minimum of 165 degrees Fahrenheit.
(9) Freezers must be kept at a temperature of 0 degrees Fahrenheit or below and refrigerators must be 41 degrees Fahrenheit or below. Thermometers must be placed in the warmest area of the refrigerator and freezer to assure proper temperature.
(10) Food must be prepared and served with the least possible manual contact, with suitable utensils, and on surfaces that have been cleaned, rinsed, and sanitized before use to prevent cross-contamination.
(11) Facilities must prepare food in accordance with established food preparation practices and safety techniques.
(12) A food service employee, while infected with a communicable disease that can be transmitted by foods, or who is a carrier of organisms that cause such a disease or while afflicted with a boil, an infected wound, or an acute respiratory infection, must not work in the food service area in any capacity in which there is a likelihood of such person contaminating food or food-contact surfaces with pathogenic organisms or transmitting the disease to other persons.
(13) Effective hair restraints must be worn to prevent the contamination of food.
(14) Tobacco products must not be used in the food preparation and service areas.
(15) Kitchen employees must wash their hands before returning to work after using the lavatory.
(16) Dishwashing chemicals used in the kitchen may be stored in plastic containers if they are the original containers in which the manufacturer packaged the chemicals.
(17) Sanitary dishwashing procedures and techniques must be followed.
(18) Facilities that house 17 or more residents must comply with 25 TAC Chapter 228, Subchapters A – J (relating to Texas Food Establishment Rules) and local health ordinances or requirements must be observed in the storage, preparation, and distribution of food; in the cleaning of dishes, equipment, and work area; and in the storage and disposal of waste.
- (2) At least three meals or their equivalent must be served daily, at regular times, with no more than a 16-hour span between a substantial evening meal and breakfast the following morning. All exceptions must be specifically approved by DADS.
Pay close attention to dining times! This is a sneaky area that many facilities fail to realize they are not in compliance with, especially when it comes to residents in the memory care setting which typically have a more structured time frame for dining.
- (3) Menus must be planned one week in advance and must be followed. Variations from the posted menus must be documented. Menus must be prepared to provide a balanced and nutritious diet, such as that recommended by the National Food and Nutrition Board. Food must be palatable and varied. Records of menus as served must be filed and maintained for 30 days after the date of serving.
Ensure your food service director is in compliance with this regulation. They should have a binder that tracks the menus for the minimum standard of 30 days, but I recommend keeping 90 days’ worth of menus on file.