Last updated on June 15th, 2023
December is Worldwide Food Service Safety Month, meaning this is the perfect time for food service providers to take a closer look at how they’re preparing and serving food to diners. This is also an excellent time for healthcare providers to reevaluate food safety procedures to ensure residents stay safe throughout the next year and beyond.
According to the Centers for Disease Control and Prevention (CDC), there are more than 250 foodborne diseases. Most of these infections are caused by various bacteria, viruses, and parasites. However, you can prevent these diseases in residents and patients by following standard safety procedures.
To learn more about what healthcare communities should be focusing on regarding food safety, we interviewed Carol DeHaven, a Regional Director of Operations at Culinary Services Group. Carol has been vital in developing our safety audits and helps get all of our partner locations inspection-ready. Here’s what she had to say about food safety.
What are the biggest issues you see in long-term care kitchens when it comes to food safety?
Carol DeHaven, Regional Director of Operations, Culinary Services Group
Carol: One of the biggest issues I see across many different kitchens is what I like to call “low-hanging fruit.” What I mean by that is that some kitchens are neglecting the basics like labeling and dating standards, removing items that have exceeded their shelf life, following handwashing procedures, proper glove usage, and equipment sanitation. Another big problem I see is not allowing for the proper air drying of dishes in the dishwasher and not allowing dishes to be sanitized appropriately during drying. Not allowing items to dry thoroughly can lead to what we call “wet nesting,” which means storing wet dishes on top of each other, it’s possibly causing mold. Also, when you’re grabbing the plate later, it may have stagnant water on it that could potentially harm the food.
For some of the issues that you’ve just mentioned, how do those issues affect health inspections and the residents at long-term care communities?
Carol: All those items directly impact F-tags during a CMS inspection. For instance, an F-812 tag is about Food Procurement, Storage, Preparing, Serving, and Sanitary Conditions. Items in this tag can also affect the F-801 tag and the F-804 tag about Nutritive Value, Appearance, Palatable Food, and Temperature. For palatable food, if we’re not worried about labeling and dating, then how are we ensuring that food is discarded or kept for the proper time and that it’s still safe to eat?
On top of that, each tag often directs you to another tag to look at. So, if we’re doing a mock survey and are looking at F-812, which is a sanitation tag, and we find an issue, it will direct us to a few other tags to look at. Every tag impacts the larger scope, and it may impact other departments. That alone can affect morale, the community’s reputation, and the people running the kitchen.
The impact that it has on residents is even more significant. This could affect their quality of life, and they could stop eating their meals or start losing weight, which creates a whole new issue. Then, your dietitians’ audits are impacted, putting more work on them.
The elderly and the young are the most susceptible groups to foodborne illness. So those “low hanging fruits” that we discuss so often, as far as labeling and dating, the hierarchy of refrigerator items that you’re storing, and the storing of food that’s past its expiration date, can all cause foodborne illness to happen. That can impact lives and your community on multiple levels.
What are some of the kinds of foodborne illnesses that can occur around that “low hanging fruit” that you’ve mentioned?
Carol: Salmonella, E Coli, Listeria, and many, many more. If you look at the scope of impact, you’re more than likely not affecting just one resident because anything that a large group is consuming can affect many people at several different levels of the community.
What is your plan of action if a kitchen isn’t up to par, or if you’re walking into a new community, how do you get a kitchen up and running the way it should be?
Carol: If you’re walking into a new kitchen, it’s really easy to become overwhelmed with tasks. I like to break it into the “Four Quadrant System.” This means separating tasks by what’s Urgent and Important, Not Urgent but Important, Urgent but Not As Important, and Not Urgent and Not Important.
Things that will have the most significant impact on the operation, the residents, and the community would obviously be Urgent and Important and need to be worked on immediately. When breaking down those tasks and putting them into a plan, I like to include the team and help them understand why we need to do these things. Explain the consequences and the outcome for the people you’re serving and how you’re affecting their quality of life by making these very basic changes. During that process, keep the team’s morale up by working with them side-by-side in the kitchen and marking items off as they’re completed. By including them in the whole process, you get more buy-in and willingness to help.
As you’re moving through the plan, be sure to follow up daily to ensure items are staying complete and you’re creating new habits. It’s one thing to do the plan and work through it, but if you’re not following up regularly, your kitchen will return to where it was.
How do you train staff to be well prepared for food safety in the kitchen?
Carol: I find it best to go into their training with a plan. I don’t like to bring people in without having a format of how I’m going to train them with the skills that they need. They need to do their job, be safe doing their job, and keep others safe while they’re doing their job. I always like to ensure they’re assigned a qualified trainer. While they’re training, make sure that you allow time in the plan for discussions, questions, and open communication. They should follow up with the department head throughout the day, and at the end of the day, check in with them to see how things are going and make sure that they’re getting everything they need from their trainer. I also like to give small quizzes on food handling training basics, so staff is aware of the impact of what they’re doing.
One last question, how can long-term care kitchens remain inspection-ready throughout the year? What are some things that you recommend?
Carol: I believe in the basics of what we do and why we do them. I think completing daily and weekly F-812 audits are essential to capturing some of that “low hanging fruit.” Be honest with yourself and your results to allow growth within your department. It’s okay to take a step back as long as you recognize it, learn from it, and move forward. Ensure items are fixed quickly within your department so you can stay inspection ready by not allowing things to build up. Then, it might get too overwhelming to correct. Also, ensure that cleaning assignments are being signed and completed daily, weekly, monthly, and whenever else they’re needed. In today’s world of short-staffing, it’s really easy to let certain items go, but the longer you neglect these items, the more you allow yourself to become unready for inspections. Although you’re short-staffed and have challenges in kitchens, you must allow yourself time in your schedule to make sure you’re inspection-ready.
Want more information about kitchen safety? Check out our F-tag food safety resource page here to learn about everything you need to do to keep your kitchens inspection-ready. If you have any questions for Carol or the rest of our food safety team, feel free to contact us here.
