Healthcare facilities serving a vulnerable population must be able to sustain themselves for several days independent of outside resources, regardless of whether the situation is an unanticipated emergency or a planned shutdown. Recently, a healthcare facility in CA was cited for an immediate jeopardy during a survey for potential for food borne illness related to mold in a walk-in refrigerator.
What meal service options are available when you can’t serve any of the food stored in the refrigerator? The regular written menus cannot be followed with no available perishable food to use. Replacement food must be brought in and an acceptable alternate cold storage solution must be identified and implemented. From the food service perspective, there can be no disruption and kitchen staff must be able to continue just as they would during an emergency.
So, what are your options for meal service, and how long will they take to implement?
- Purchase home-type refrigerators for interim use: You must consider if the appliances are acceptable to the surveyors; do they have the approvals for commercial use such as UL, or NSF? Can they maintain the safe temperatures with frequent use and constant opening? Do they meet the other requirements for life safety codes, building codes, etc.?
- Reach out to neighboring healthcare facilities to request use of their refrigerators: You would need to consider how to transport the perishables and how to keep them at safe temperatures during the process. http://www.foodtodonate.com/images/foodSafety/CambroCamcarrier_large.jpg
- Obtain a refrigerated truck and keep on the premises for interim use until the walk-in refrigerator is repaired, replaced, or satisfactorily sanitized for use: This entails obtaining appropriate permits, parking space allowance, gas for the vehicle/generator, monitoring the temperatures in the cooler for safe temperature maintenance, and of course the cost of rental and fuel replenishing needs to be factored in as well.
- Rebuild, repair, or replace the offending walk-in refrigerator: This will require permits, licenses, etc. from local and state health departments and contractors, permits and inspections. It also takes a great deal of time to get in the queue for state or local authorities to inspect and approve, as well as high cost.
What are the options to continue to serve balanced nutritious meals in the interim?
- Canned foods: Expensive, not friendly for therapeutic diets, not always palatable.
- Frozen entrees: Must be purchased, heated and served each day; leftovers or uncooked portions must be discarded if refrigeration is not available- very costly.
- Fresh food: Must be purchased and prepared each day, extra portions will be discarded. Use home refrigerators or ice chests to keep cold until service- may not meet temperature requirements.
- Designated emergency meal supply: Do you have some components of the menu that still requires refrigeration- tuna sandwiches, egg salad sandwiches, milk, etc.?
Whatever your plan, consider how you will manage without refrigeration and cooking, and how will you keep the meals at safe temperatures. Shelf-stable meals such as Meals for All may be the better option; no refrigeration required, no cooking required, and no utilities needed. Time is the public health control, and meals are safe to consume within 4 hours of preparation. The walk-in refrigerator may take several days to replace or repair and you need a safe, cost-effective, nutritionally appropriate option to serve the healthcare facility patrons.