Managing the culinary program

Managing the culinary program

As many operators of community-based residential facilities 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 Wisconsin Department of Health and Family Services, will keep you in the clear for any potential issues with state surveyors:

DHS 83.41Food service.

(1)  General requirements.

(a) Food supply.

  1. The CBRF shall maintain a food supply that is adequate to meet the needs of the residents.
  2. Food shall be obtained from acceptable sources.

(b) Equipment. The CBRF shall store equipment and utensils in a clean manner and shall maintain all utensils and equipment in good repair.

(c) Dishwashing.

  1. Whether washed by hand or mechanical means, all equipment and utensils shall be cleaned using separate steps for pre-washing, washing, rinsing and sanitizing. Residential dishwashers may be used in kitchens serving 20 or fewer residents. Kitchens serving 21 or more residents shall have a commercial type dishwasher for washing and sanitizing equipment and utensils in accordance with standard practices described in the Wisconsin food code.
  2. A 3-compartment sink for washing, rinsing and sanitizing utensils, with drain boards at each end is required for all large facilities with a central kitchen. Washing, rinsing and sanitizing procedures shall be in accordance with standard practices described in the Wisconsin food code. In addition, a single compartment sink or overhead spray wash located adjacent to the soiled drain board is required for pre-washing.

(2) Nutrition.

(a) Diets.

  1. The CBRF shall provide each resident with palatable food that meets the recommended dietary allowance based on current dietary guidelines for Americans and any special dietary needs of each resident.
  2. The CBRF shall provide a therapeutic diet as ordered by a resident’s physician.

Note: To obtain information on the Dietary Guidelines for Americans, see www.usda.gov/cnpp.

(b) Meals.

  1. The CBRF shall provide meals that are routinely served family or restaurant style, unless contraindicated in a resident’s individual service plan or for short-term medical needs.
  2. The CBRF shall provide at least 3 meals a day, unless otherwise arranged according to the program statement or the resident’s individual service plan. A nutritious snack shall be offered in the evening or more often as consistent with the resident’s dietary needs.
  3. If a resident is away from the CBRF during the time a meal is served, the CBRF shall offer food to the resident on the resident’s return.

(c) Menus.

  1. The CBRF shall make reasonable adjustments to the menu for individual resident’s food likes, habits, customs, conditions and appetites.
  2. The CBRF shall prepare weekly written menus and shall make menus available to residents. Deviations from the planned menu shall be documented on the menu.

(3) Sanitation and safety.

(a) Infection control.

  1. Each employee who prepares or serves food shall be free from open, infected wounds and from communicable disease and shall maintain clean and safe work habits.
  2. The CBRF shall provide hand-washing facilities in the kitchen for use by food handlers. Use of a common towel is prohibited.

(b) Food safety. Whether food is prepared at the CBRF or off-site, the CBRF shall store, prepare, distribute and serve food under sanitary conditions for the prevention of food borne illnesses, including food prepared off-site, according to all of the following:

  1. The CBRF shall refrigerate all foods requiring refrigeration at or below 40°F. Food shall be covered and stored in a sanitary manner.
  2. The CBRF shall maintain freezing units at 0°F or below. Frozen foods shall be packaged, labeled and dated.
  3. The CBRF shall hold hot foods at 140°F or above and shall hold cold foods at 40°F or below until serving.

(c) Reporting. The CBRF is required under s. DHS 145.04 to report suspected incidents of food borne disease to the local public health officer.

Top Takeaways:

  • The CBRF shall provide a therapeutic diet as ordered by a resident’s physician.

The facility must take the varying needs of residents due to their medical and dietary needs. Having a culinary program that is flexible and accommodating is key to avoiding potential issues.

  • (b)Food safety. Whether food is prepared at the CBRF or off-site, the CBRF shall store, prepare, distribute and serve food under sanitary conditions for the prevention of food borne illnesses, including food prepared off-site, according to all of the following: 1-3

This reg is one that is required to meet the standard of both the DHFS 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:

  1. 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.
  2. Ask your residents what they would like to see on the menu. This will drastically improve the satisfaction of your foodservice program if residents are giving input into their food choices.

 

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