Louisiana Administrative Code
Title 48 - PUBLIC HEALTH-GENERAL
Part I - General Administration
Subpart 3 - Licensing and Certification
Chapter 82 - Minimum Standards for Licensure of Hospice Agencies
Subchapter E - Hospice Inpatient Facility
Section I-8255 - Nutritional Services
Universal Citation: LA Admin Code I-8255
Current through Register Vol. 50, No. 9, September 20, 2024
A. Nutritional services shall be under the supervision of a registered dietitian, licensed to practice in Louisiana, who is employed either full-time, part-time or on a consulting 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.
1. 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. The registered dietician is also responsible for:
a. recording the nutritional status of the
patient;
b. plan menus for those
patients who require medically prescribed special diets; and
c. supervise the preparation and serving of
meals to ensure that the patient accepts the special diet.
2. The hospice inpatient facility shall have
a dietary manager who is responsible for:
a.
planning menus that meet the nutritional needs of each patient, following the
orders of the patient's licensed medical practitioner 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.
b. supervising the meal preparation and
service to ensure that the menu plan is followed.
3. A dietary manager shall meet one of the
following:
a. a graduate of a dietetic
technician or dietetic assistant training program by correspondence or
classroom, approved by the American Dietetic Association;
b. a graduate of a State approved course that
provides 90 or more hours of classroom instruction in food service supervision
and has experience as a supervisor in a health care institution with
consultation from a dietitian; or
c. has training and experience in food
service supervision and management in the military or other service equivalent
in content to a dietetic technician or dietetic assistant training program by
correspondence or classroom, approved by the American Dietetic
Association.
4. The
hospice shall employ sufficient support personnel to meet the needs of the
patients in the hospice inpatient facility.
5. The hospice shall have policies and
procedures to ensure support personnel are competent to perform their
respective duties within the dietary services department.
6. The hospice inpatient facility shall:
a. serve at least three meals or their
equivalent each day at regular times, with not more than 14 hours between a
substantial evening meal and breakfast;
b. 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;
c. be designed and equipped to
procure, store, prepare, distribute, and serve all food under sanitary
conditions; and
d. 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 provisions 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.
B. Sanitary Conditions
1. Food shall be in sound condition, free
from spoilage, filth, or other contamination and shall be safe for human
consumption.
a. All food shall be procured
from sources that comply with all laws and regulations related to food and food
labeling.
b. The use of food in
sealed containers that was not prepared in a food processing establishment is
prohibited.
c. 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 40 degrees Fahrenheit, except when being prepared and served.
Refrigerator temperatures shall be maintained at 40 degrees Fahrenheit or
below; freezers at 0 degrees Fahrenheit or below.
d. Hot foods shall leave the kitchen or steam
table at or above 140 degrees Fahrenheit. In-room delivery temperatures shall
be maintained at 120 degrees Fahrenheit, or above for hot foods and 50 degrees
Fahrenheit or below for cold items. Food shall be covered during transportation
and in a manner that protects it from contamination while maintaining required
temperatures.
e. 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 degrees Fahrenheit during the wash cycle (or
according to the manufacturer's specifications or instructions) and 180 degrees
Fahrenheit for the final rinse. Low temperature machines shall maintain a water
temperature of 120 degrees Fahrenheit with 50 ppm (parts per million) of
hypochlorite (household bleach) on dish surfaces. For manual washing in a
3-compartment sink, a wash water temperature of 75 degrees Fahrenheit with 50
ppm of hypochlorite or equivalent, or 12.5 ppm of iodine; or a hot water
immersion at 170 degrees Fahrenheit 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. Effective with the promulgation of these
requirements, an additional lavatory shall be provided in the dishwasher area
in newly constructed hospices or in existing hospices undergoing major dietary
alterations.
f. No staff, including
dietary staff, shall store personal items within the food preparation and
storage areas.
g. 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.
h. Toxic items such as
insecticides, detergents and polishes shall be properly stored, labeled and
used in accordance with manufacturers guidelines.
i. 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. 40:2181-2191.
Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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