Current through Register Vol. 35, No. 6, March 26, 2024
The facility shall provide planned and nutritionally balanced
meals from the basic food groups in accordance with the "recommended daily
dietary allowance" of the American dietetic association, the food and nutrition
board of the national research council, or the national academy of sciences.
Meals shall meet the nutritional needs of the residents in accordance with the
"2005 USDA dietary guidelines for Americans." Vending machines shall not be
considered a source of snacks.
A.
Dietary services policies and procedures. The facility will
develop and implement written policies and procedures that are maintained on
the premises and that govern the following requirements.
(1)
Meal service. The facility
shall:
(a) serve at least three (3) meals or
their equivalent each day at regular times with no more than sixteen (16) hours
between the evening meal and morning meal with snacks freely
available;
(b) provide snacks of
nourishing quality and post on the daily menu;
(c) develop menus enjoyed by the residents
and served at normal intervals appropriate to the residents'
preferences;
(d) post the weekly
menu, including snacks where residents and families are able to view it; posted
menus shall be followed and any substitution shall be of equivalent nutritional
value and recorded on the posted menu; identical menus shall not be used within
a one (1) week cycle;
(e) have
special menus or meal items following guidelines from the resident's physician
for residents who have medically prescribed special diets;
(f) serve all residents in a dining room
except for residents with a temporary illness, or with documented specific
personal preference to have meals in their room;
(g) allow sufficient time for meals to enable
residents to eat at a leisurely pace and to socialize; and
(h) contact the resident's PCP within
forty-eight (48) hours if a resident consistently refuses to eat.
(2)
Staff in-service
training. The facility shall provide an in-service training program for
staff that are involved in food preparation at orientation and at least
annually and that includes:
(a) instruction in
proper food storage;
(b)
preparation and serving food;
(c)
safety in food handling;
(d)
appropriate personal hygiene; and
(e) infectious and communicable disease
control.
B.
Dietary records. The facility shall maintain the following
documentation onsite:
(1) a systematic record
of all menus and revisions, including snacks, for a minimum of thirty (30)
calendar days;
(2) a systematic
record of therapeutic diets as prescribed by a PCP;
(3) a copy of the most recent licensing
inspection and for facilities with 10 or more residents, a copy of the New
Mexico environment department inspection with notations made by the facility of
action taken to comply with recommendations or citations; and
(4) a daily log of the recorded temperatures
for all facility refrigerators, freezers and steam tables maintained and
available for inspection for thirty (30) calendar days.
C.
Clean and sanitary
conditions. All practices shall be in accordance with the standards of
the state environment department, pursuant to 7.6.2 NMAC.
(1)
Kitchen sanitation.
(a) Equipment and work areas shall be clean
and in good repair. Surfaces with which food or beverages come into contact
shall be of smooth, impervious material free of open seams, not readily
corrodible and easily accessible for cleaning.
(b) Utensils shall be stored in a clean, dry
place protected from contamination.
(c) The walls, ceiling and floors of all
rooms that food or drink is stored, prepared or served shall be kept clean and
in good repair.
(2)
Washing and sanitizing kitchenware.
(a) All reusable tableware and kitchenware
shall be cleaned in accordance with procedures that include separate steps for
prewashing, washing, rinsing and sanitizing.
(b) Proper dishwashing procedures and
techniques shall be utilized and understood by the dishwashing staff.
(c) Periodic monitoring of the operation of
the detergent dispenser, washing, rinsing and sanitizing temperatures shall be
performed and documented.
(d) When
a dishwashing machine is utilized, the cleanliness of the machine, its jets and
its thermostatic controls shall be monitored and documented by the facility. A
monthly log of the recorded temperature of the dishwasher shall be maintained
in the facility and available for inspection.
(3) Sinks for hand washing shall include hot
and cold running water, hand-washing soap and disposable towels.
(4) All garbage and kitchen refuse that is
not disposed of through a garbage disposal unit shall be kept in watertight
containers with close-fitting covers and disposed of daily in a safe and
sanitary manner.
(5) Cooks and food
handlers shall wear clean outer garments and hair nets or caps and shall keep
their hands clean at all times when engaged in handling food, drink, utensils
or equipment in accordance with the local health authority. Disposable gloves
shall be used in accordance with the local health authority.
D.
Food management.
The facility shall store, prepare, distribute and serve food under sanitary
conditions and in accordance with the regulations governing food establishments
of local health authority having jurisdiction, 7.6.2 NMAC.
(1) The facility shall ensure that a minimum
of a three (3) calendar day supply of perishables and a five (5) calendar day
supply of non-perishables or canned foods is available for the
residents.
(2) The facility
refrigerator and freezer shall have an accurate thermometer which reads within
or not more than plus or minus three (3) degrees fahrenheit of the required
temperature, located in the warmest section of the refrigerator and freezer and
shall be accessible and easily read.
(a) The
temperature of the refrigerator shall be thirty-five (35) - forty-one (41)
degrees fahrenheit.
(b) Freezer
temperatures shall be maintained at zero (0) degrees fahrenheit or
below.
(3) Refrigerators
and freezers shall be kept clean and sanitary at all times. Food stored in
refrigerators and freezers shall be covered, dated and labeled. Unused leftover
food shall be discarded after three (3) calendar days.
(4) Steam tables, hot food tables, slow
cookers, crock pots and other hot food holding devices shall not be used in
heating or reheating food. Hot food temperatures shall be checked periodically
to insure that a minimum of one hundred forty (140) degrees fahrenheit is
maintained.
(5) Medication,
biological specimens, poisons, detergents and cleaning supplies shall not be
kept in the same storage areas used for storage of foods. Medications shall not
be stored in the refrigerator with food; an alternate refrigerator for
medication shall be used pursuant to Subsection B of 7.6.2.8 NMAC.
(6) Canned or preserved foods shall be
procured from sources that process the food under regulated quality and
sanitation controls. This does not preclude the use of local fresh produce. The
facility shall not use home-canned foods.
(7) Dry or staple food items shall be stored
at least six (6) inches off the floor in a ventilated room that is not subject
to sewage, waste water back-flow or contamination by condensation, leakage,
rodents or vermin.
(8) The facility
shall ensure the following:
(a) all
perishable food is refrigerated and the temperature is maintained no higher
than forty-one (41) degrees fahrenheit;
(b) the temperature for all hot foods is
maintained at one hundred forty (140) degrees fahrenheit; and
(c) all displayed or transported food is
protected from environmental contamination and maintained at proper
temperatures in clean containers, cabinets or serving carts.
E.
Milk.
(1) Raw milk shall not be used.
(2) Condensed, evaporated, or dried milk
products that are nationally recognized may be employed as "additives" in
cooked food preparation but shall not be substituted or served to residents in
place of milk.
F.
Collateral requirements. Compliance with this rule does not relieve a
facility from the responsibility of meeting more stringent municipal
regulations, ordinances or other requirements of state or federal laws
governing food service establishments. Local health authority having
jurisdiction means municipal, county, state or federal agency(s) that have laws
and regulations governing food establishments, liquid waste disposal, treatment
facilities and private wells.