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Dietary Services - Food Preparation and Storage

Description of Federal Requirements
Comparison of State Requirements
Table Comparing States

Complete Transcript of State Requirements on Food Preparation and Storage (PDF)


Federal Regulations & Related F-tags for 483.40 Applicable Federal Regulation
(d) Food | F364
(3) Food preparation | F365
(4) Food substitutes | F366
(2) Storage | F371

  • 483.35 Dietary Services
  • Subpart D - Requirements That Must be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants
  • Description of Federal Requirements    (TOP)    (NEXT)

    Federal regulations require that the facility must provide each resident with a nourishing, palatable, well balanced diet that meets the daily nutritional and special dietary needs of each resident. The facility must provide food prepared by methods that conserve nutritive value, flavor, and appearance; food that is palatable, attractive, and at the proper temperature; and food that is prepared in a form designed to meet individual needs (F-364, F-365, F-366). The facility must procure food from sources approved or considered satisfactory by Federal, State, or local authorities and store, prepare, distribute, and serve food under sanitary conditions (F-370, F-371, F-372).

    Comparison of State Requirements    (TOP)    (NEXT)

    NOTE:  The examples below may not list all States with similar language; always check your state for specifics.

    The Federal regulations require that nourishing and palatable food be provided to residents but is rather silent on how that process is to take place; how the food is to be prepared; standards for food supplies; storage of food; temperature and general food hygiene. Florida and Montana have extensive and informative regulations that could serve as an example for other states although the  regulations are not specific to nursing home rather they pertain to all food service establishments and theaters serving food or drink to the public. Florida regulations start with forty-two comprehensive definitions beginning with adulterated food. Regulations for quality of food include milk and milk products, frozen desserts, shellfish, meat and meat products, eggs, and packaged foods. An extensive section on food protection addresses perishable foods and temperature, requiring all potentially hazardous food shall be kept at 41 degrees F or below and 140 degrees F or above, except during necessary periods of preparation and service. An example of how detailed the regulations are is the following regulation for cooling a large volume of food. Potentially hazardous foods of large volume or prepared in large quantities shall be rapidly cooled, utilizing one or more of the following methods based on the type of food being cooled: placing the food in shallow pans; separating food into smaller or thinner portions; using rapid cooling equipment; stirring the food in a container placed in an ice water bath; using containers that facilitate heat transfer; adding ice as an ingredient; or other approved methods. Extensive regulations address methods for cooking meat and other products. A section on food equipment and utensils addresses American National Standards for equipment.

    Standards for Food Supplies    (TOP)    (NEXT)

    States differ considerably on standards for food supplies. Alaska simply states that a facility must maintain adequate space, equipment, and staple food supplies to provide food service to patients in emergencies. Arkansas requires supplies of perishable foods for a 1 day period and of nonperishable foods for a 3 day period shall be on the premises at all times to meet the requirements of the planned menus. If the facility consistently does not have the required supplies, the Department will require that the facility alter its food delivery schedule to meet regulations. In CaliforniaSouth Carolina, Massachusetts and Maine, at least one week’s supply of staple foods and at least 2 days supply of perishable foods shall be maintained on the premises. Iowa, UtahNebraska and Louisiana require at least 1 week of staple foods and a 3 day supply of perishable foods be maintained.Connecticut and Indiana require a least a 3-day supply of staple foods at all time. Delaware requires a 2-day supply of food for emergency feeding be kept on the premises. (Items that need little or no water and heat to be served/readied are recommended.) GeorgiaNew Hampshire and Mississippi require sufficient perishable foods for a 24-hour period and nonperishable foods for a 3-day period.  South DakotaWest Virginia and Tennessee require an on-site supply of nonperishable foods adequate to meet the requirements of planned menus for 3 days be maintained.

    Quality of Food   (TOP)   (NEXT)

    In California, food in unlabeled, rusty, leaking, broken containers or cans with side seam dents, rim dents or swells shall not be retained or used. Milk when served as a beverage, shall be pasteurized Grade A or certified unless otherwise prescribed by the physician’s diet order. Milk, milk products and products resembling milk shall be processed or manufactured in milk product plants meeting the requirements of Division 15 of the California Food and Agricultural Code. Powdered milk shall not be used as a beverage but may be used in cooking. Milk shall be served in individual containers or from a dispensing device which has been approved for such use, by the local health department or from the original container. Milk shall be dispensed directly into the glass or other container from which the patient drinks. Spoiled or contaminated food shall not be served.

    In Colorado, milk for drinking shall be provided to consumers in an unopened commercially filled container not exceeding a one pint capacity. In Maine, the use of second grade or outdated products, unlabeled canned goods, railroad salvage, and similar foods is prohibited. Fresh and frozen shucked shellfish shall be obtained in non-returnable packages legibly bearing the processor’s name, address and authorized certification number. Shell stock and shucked shellfish shall be kept in the container in which they were received until they are used. Sulfites may not be added to raw or cooked fruits or vegetable, nor monosodium glutamate added to any food prepared in the facility. All dented cans of food must be removed from the food storage area and may not be used for resident consumption. Un-served food from previously prepared menus must be discarded after 36 hours. Foods that may be frozen safely, such as meat, may be frozen, retained and used according to accepted time frames for such process. In Minnesota, non-prohibited food items from non-commercial sources such as fresh produce, game, and fish may be brought into the nursing home in accordance with nursing home policy. In New Mexico, food served to a resident in an unopened manufacturer’s package may not be re-served unless the package remains unopened and maintained at the proper temperature. In New York, the facility shall provide, as part of the basic services, kosher food or food products prepared in accordance with the Hebrew Orthodox religious requirements when the resident, as a matter of religious belief, desires to observe Jewish dietary laws; and shall 1) establish a plan and procedure for obtaining, preparing and serving kosher foods and food products in accordance with Hebrew Orthodox religious requirements and incorporate the provision of kosher food and food products prepared in accordance with Hebrew Orthodox religious requirements into the resident’s care plan.

    Food Storage Space    (TOP)    (NEXT)

    Arkansas requires an adequately sized storage room with adequate shelving. Food in any form shall not be stored on the floor. Seamless containers with tight fitting lids, clearly labeled, shall be provided for bulk storage of dry foods. All food stored in the refrigerator shall be stored in covered containers. Leftover foods shall be labeled and dated with the date of preparation. Foods stored in freezers shall be wrapped in air-tight packages, labeled and dated. Eggs shall be stored below all other foods in the refrigerator. Fresh whole eggs shall not be cracked more than 2 hours before use. Kansas requires a control station for receiving food supplies and enough storage space for food for at least 4 days. Oregon requires storage space for 7 days supply including cold storage for 2 days’ food needs. Maryland recommends 2 square feet per patient be provided for dry food storage space while Mississippi requires 2 ½ sq. feet per bed and the width of the aisle shall be a minimum of 3 feet. In Minnesota, the storage of nonperishable food in toilet rooms or vestibules is prohibited.

    Preparation of Food  (TOP)    (NEXT)

    In Arkansas, all food prepared in the nursing home shall be clean, wholesome, free from spoilage and so prepared as to be safe for human consumption. Fresh fruits and vegetables shall be thoroughly washed in clean, safe water before use. Vegetables subject to dehydration during storage shall be wrapped or bagged in plastic. The use of tobacco in any form is prohibited where food or drink is prepared, stored, cooked, or where dishes or pots and pans are washed or stored.  In Massachusetts, house diets shall be appropriately seasoned in cooking and this shall include salt. Also, no drugs shall be stored in the same refrigerator with food, and drugs shall not be added to foods in the kitchen.

    Food Preparation Area  (TOP)    (NEXT)

    Kansas requires food preparation facilities that include space and equipment for preparing, cooking, baking, and serving. There shall be a two-compartment sink for food preparation and for facilities constructed after 1977 there shall be a sink for food preparation. In Maine, kitchens shall be segregated from other areas and large enough to allow for adequate equipment to prepare and care for food properly. Ventilation must be provided to maintain food integrity and reasonable comfort of the staff. All new construction shall have a 3 compartment ware-washing sink (at least 12 inches deep) and a separate hand-washing sink conveniently available. In Maryland, the kitchen may not be used as a passageway. In Mississippi, the minimum area of food preparation space for less than 25 beds is 200 sq. feet, for 25 to 60 beds, a minimum of 10 sq. feet per bed shall be provided, in facilities with 61 to 80 beds a minimum of 6 sq. feet per bed shall be provided and in facilities with 81 to 100 beds, a minimum of 5 sq. feet per bed shall be provided for each bed over 80. An office shall be provided near the kitchen for the use of the food service supervisor. At a minimum, the space provided shall be adequate for a desk, 2 chairs and a filing cabinet.

    Temperature  (TOP)    (NEXT)

    Arkansas requires cold food to be served to the patients between 45 – 55 degrees F and hot foods should register 140 degree F on the steam table and should reach the patient at no less than 115 degrees F. All readily perishable foods, including eggs or fluids, shall be stored at or below 45 degrees F. A reliable and visible thermometer shall be kept in the refrigerator. All frozen foods shall be stored at 0 degrees F. or lower. Frozen foods which have been thawed shall not be refrozen. Potentially hazardous frozen foods shall be thawed at refrigerator temperatures of 45 degrees F or below. Idaho and California require cold food be kept at 45 degrees F and hot food be kept over 140 degrees F. In California, there shall be an accurate thermometer in each refrigerator and freezer and in storerooms used for perishable foods. In Colorado, walk-in refrigerators and freezers shall have inside lighting and inside lock releases. In new construction, there shall be an alarm system that is clearly audible throughout the food preparation and storage areas of the facility. Hawaii requires perishable foods shall be stored at the proper temperatures to conserve nutritive values and prevent spoilage. Iowa requires potentially hazardous food that is cooked, cooled and reheated for hot holding shall be reheated so that all parts of the food reach a temperature of at least 165 degrees F. Food must be reheated within no more than 2 hours after the heating process begins. In Louisiana, hot foods shall leave the kitchen or steam table according to State Sanitary Code and in-room delivery temperatures shall be maintained according to code. Maine requires a thermometer accurate to +3 degrees F shall be located inside each refrigerator, freezer or other storage space used for potentially hazardous food and that food will be kept at 41 degrees F or below. Minnesota requires potentially hazardous food be maintained at 40 degrees F or below or 150 degrees F or above. In Mississippi, recommended temperature for storing perishable foods are 32-40 degrees F for meats and dairy products and 40 degrees to 45 degrees for fruits and vegetables. If it is impractical to provide separate refrigeration, the temperature shall be maintained at 41 degrees F. Homes with more than 24 beds shall have commercial or institutional type refrigeration. Montana regulations include a table that specifies an item, the required temperature and the time required for measuring the temperature. Oklahoma requires hot foods be served at a palatable temperature range of 110-120 degrees F, milk be stored between 35-40 degrees F and that the maximum room temperature in the food preparation area shall not exceed 90 degrees F.

    Table Comparing States      (TOP)

    Note: If the States in this table are not hyper-linked, their provisions do not appear to address the topic, and therefore, do not alter the Federal Regulatory scope.  The Table summarizes content on Administration by State (with a link to each State's specific language).  Link to a downloadable PDF document containing all State requirements on Food Preparation and Storage.

    483.35 Dietary Services

    Food Preparation and Storage
    State Goes beyond Federal Regulations? Subjects Addressed: How State Differs From or Expands On Federal Regulations
    Alabama Yes Same as Federal Categories.
    Alaska Yes Adequate food supply.
    Arizona Yes  Food preparation requirements.
    Arkansas Yes Food storage safety; temperature; preparation & storage space; supplies of perishable foods.
    California Yes Food storage; food supplies; milk requirements; catered foods.
    Colorado Yes Space; refrigerator safety; equipment; storage of dishes and glasses; milk.
    Connecticut Yes Minimum supplies on hand; consider cultural backgrounds of patients.
    Delaware Yes Minimum supplies on hand; food storage.
    District of Columbia Yes Requirements for staff dress code, food temperature and food supply.
    Florida Yes Extensive regulations that cover food service establishments and theaters; food hygiene; definitions; food supplies; food protection; food equipment and utensil’s.
    Georgia Yes Minimum supplies on hand.
    Hawaii Yes Food storage.
    Idaho Yes Food purchasing; storage; temperature.
    Illinois Yes Minimum supplies on hand; records; food preparation and service.
    Indiana Yes Procure food; store; prepare; storage space.
    Iowa Yes Food preparation; dietary ordering; milk products; storage.
    Kansas Yes Storage; equipment; food preparation; food supplies.
    Kentucky Yes Same as Federal Categories.
    Louisiana Yes Food supply; State Sanitary Code; food storage; food source.
    Maine Yes Extensive regulations for food supplies; food storage and protection; food preparation; dietary areas; dry storage.
    Maryland Yes Preparation of food; dietetic service area; limitations on use of kitchen; kitchen space requirements; pantries; dry food storage; refrigerated storage.
    Massachusetts Yes Milk products; preparation of food; food safety; food storage; written reports; transporting food; auxiliary kitchens; no drugs stored in food refrigerator.
    Michigan Yes Written policies for rood storage and preparation.
    Minnesota Yes Food supplies; food temperatures; ice; milk products.
    Mississippi Yes Food handling procedures; food preparation; food supply; refrigeration facilities; areas and equipment; refrigerators and freezers; food storage.
    Missouri Yes Minimum supplies on hand.
    Montana Yes Regulations cover all state food service entities; food supplies; food storage and protection; food preparation; extensive temperature regulations; food display and service; food transportation; equipment; utensils.
    Nebraska Yes Food supplies; food preparation.
    Nevada Yes Adequate facilities and equipment.
    New Hampshire Yes Minimum food supplies; food storage; food preparation.
    New Jersey Yes Safe food handling in accordance with the New Jersey Sanitary Code.
    New Mexico Yes Re-service of food; temperature; food supplies; food preparation; milk; storage and handling of food; temperature.
    New York Yes Obtaining, preparing and serving kosher food; sanitary conditions.
    North Carolina Yes Food temperature; preparation.
    North Dakota Yes Food temperature; preparation.
    Ohio Yes Food preparation; palatable drinking water; food storage.
    Oklahoma Yes Control station for receiving food; minimum food supply; storage; food .preparation; kitchen temperature; milk safety.
    Oregon Yes Food preparation areas; food receiving, food storage; food preparation and service.
    Pennsylvania Yes Sufficient food supply; ice containers and storage; kitchen space.
    Rhode Island Yes Storage space; equipment; diet kitchens; food preparation; minimum supply of food.
    South Carolina Yes Records of food purchased; minimum supply of food; approved source of food; milk; food protection; preparation and serving of food; refrigeration; ice; drinking water.
    South Dakota Yes Food safety; milk; food supply; food preparation.
    Tennessee Yes Minimum supply of food; refrigeration; perishable food; written policies.
    Texas Yes Minimum supply of food; storage areas; food preparation; food source.
    Utah Yes Minimum supply of food.
    Vermont Yes Mirrors Federal regulations.
    Virginia Yes Food preparation area; control station for receiving food; standards for food storage space; equipment.
    Washington Yes Sanitary procedures and storage.
    West Virginia Yes Meals prepared and served the same day; food temperature; food prepared with salt; emergency supplies
    Wisconsin Yes Food reserve; temperature of food; sufficient food prepared to meet resident's needs
    Wyoming No Wyoming regulations do not contain specific content for Preparation & Storage of Food

    Complete Transcript of State Requirements on Food Preparation and Storage    (TOP)