La. Admin. Code tit. 48 § I-8083

Current through Register Vol. 50, No. 9, September 20, 2024

Section I-8083 - Nutritional Services

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.

La. Admin. Code tit. 48, § I-8083

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 31:458 (February 2005).

AUTHORITY NOTE: Promulgated in accordance with R.S. 40:2175.14(B).