Current through Register Vol. 50, No. 9, September 20, 2024
A.
Nutritional services shall be under the supervision of a qualified registered
dietitian, who is employed either full time, part time, on a consulting or
volunteer basis. If the registered dietitian is not full time, there shall be a
full-time dietary manager who is responsible for the daily management of
dietary services.
B. The registered
dietician shall be responsible for assuring that quality nutritional care is
provided to patients by providing and supervising the nutritional aspects of
patient care.
C. The CRCC facility
shall have a dietary manager who is responsible for:
1. planning menus that meet the nutritional
needs of each patient, following the orders of the patient's physician and, to
the extent medically possible, the recommended dietary allowances of the Food
and Nutrition Board of the National Academy of Sciences. There shall be a
current therapeutic diet manual approved by the dietician and medical staff,
and readily available to all medical, nursing, and food service personnel,
which shall be the guide used for ordering and serving diets;
2. supervising the meal preparation and
service to ensure that the menu plan is followed.
D. The CRCC facility shall:
1. serve at least three meals or their
equivalent each day at regular intervals with not more that 14 hours between a
substantial evening meal and breakfast;
2. include adequate nutritional services to
meet the patient's dietary needs and food preferences, including the
availability of frequent, small, or mechanically-altered meals 24 hours a
day;
3. be designed and equipped to
procure, store, prepare, distribute, and serve all food under the requirements
of Part XXIII (Retail Food Establishments) of the Louisiana State Sanitary Code
(LAC 51:XXIII); and
4. provide a
nourishment station which contains equipment to be used between scheduled meals
such as a warming device, refrigerator, storage cabinets and counter space.
There shall be provision made for the use of small appliances and storage. This
area shall be available for use by the patient, the patient's family,
volunteers, guests and staff.
E. Sanitary Conditions
1. Food shall be free from spoilage, filth,
or other contamination and shall be safe for human consumption.
2. All food provided by the CRCC shall be
procured from sources that comply with all laws and regulations related to food
and food labeling.
3. All food
shall be stored, prepared, distributed and served under sanitary conditions to
prevent food borne illness. This includes keeping all readily perishable food
and drink at or below 41°F, except when being prepared and served. Refrigerator
temperatures shall be maintained at 41°F or below; freezers at 0°F or
below.
4. Hot foods shall leave the
kitchen or steam table at or above 140°F. In-room delivery temperatures shall
be maintained at 120°F or above for hot foods and 50°F or below for cold items.
Food shall be covered during transportation and in a manner that protects it
from contamination while maintaining required temperatures.
5. All equipment and utensils used in the
preparation and serving of food shall be properly cleansed, sanitized and
stored. This includes maintaining a water temperature in dish washing machines
at 140°F during the wash cycle (or according to the manufacturer's
specifications or instructions) and 180°F for the final rinse. Low temperature
machines shall maintain a water temperature of 120°F with 50 ppm (parts per
million) of hypochlorite (household bleach) on dish surfaces. For manual
washing in a three-compartment sink, a wash water temperature of 75°F with 50
ppm of hypochlorite or equivalent or 12.5 ppm of iodine; or a hot water
immersion at 171°F for at least 30 seconds shall be maintained. An approved
lavatory shall be convenient and equipped with hot and cold water tempered by
means of a mixing valve or combination faucet for dietary services staff use.
Any self-closing, slow-closing, or metering faucet shall be designed to provide
a flow of water for at least 15 seconds without the need to reactivate the
faucet.
6. No staff, including
dietary staff, shall store personal items within the food preparation and
storage areas.
7. Dietary staff
shall use good hygienic practices. Staff with communicable diseases or infected
skin lesions shall not have contact with food if that contact may transmit the
disease.
8. Toxic items such as
insecticides, detergents, polishes and the like shall be properly stored,
labeled and used.
9. Garbage and
refuse shall be kept in durable, easily cleanable, insect and rodent-proof
containers that do not leak and do not absorb liquids. Containers used in food
preparation and utensil washing areas shall be kept covered after they are
filled.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
40:2175.14(B).