Current through Register Vol. 35, No. 18, September 24, 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 meals or their
equivalent each day at regular times with no more than 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 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 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 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
pre-washing, 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.
(1) The facility shall ensure that a minimum
of a three calendar day supply of perishables and a five 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 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 35 - 41 degrees fahrenheit.
(b) Freezer temperatures shall be maintained
at zero 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 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 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.
(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 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 41
degrees fahrenheit;
(b) the
temperature for all hot foods is maintained at 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.
