How to Keep Food Brought in From Outside Sources Safe

Nursing homes and other long-term care centers are responsible for providing meals for their residents.

However, residents have the freedom to order food from their favorite fast food joint or consume a special meal or treat brought in by family and friends.

While there are many safety rules for food stored, prepared, and served by the nursing home, few rules exist for how to handle food safely brought in by visitors.

This article explains everything you need to know about how to keep food brought in from outside sources safe at your nursing home or long-term care center.

Safety concerns with outside food

The biggest concern with food brought in from outside sources is whether it is safe to eat, especially since nursing home residents are a highly susceptible population.

This means they are more likely than the general public to develop a foodborne illness and experience severe symptoms as a result.

Food that was not prepared, stored, or transported safely can contain bacteria and other disease-causing organisms known as pathogens that can cause a foodborne illness.

Foods entering your facility from personal home kitchens are potentially unsafe since the average person isn’t well-versed in proper food safety principles.

And while not completely risk-free, foods prepared in a regulated foodservice facility like a nursing home are generally much safer.

This is why there are two temperature danger zones — the temperature range at which bacteria growth accelerates — to allow a greater margin of safety for the general public.

The temperature danger zone for food handlers and others in foodservice is between 41ºF and 135ºF (5ºC and 57ºC) (1).

But for people outside of foodservice, like the general public, this range is between 40ºF and 140ºF (4ºC to 140ºC) (2).

Food brought in from outside sources policy and procedures

The best way to reduce the risk of foodborne illnesses from food brought in from outside sources is to develop a policy and procedure.

This ensures that dietary staff and other nursing home employees understand exactly what to do in this situation to protect the resident receiving the food but also other residents.

Here are the most important factors to consider when developing the procedures for food brought in from outside sources:

• Outside food should never enter your center’s kitchen to prevent contamination in case the food is unsafe.
• Allow residents to store the food in their personal refrigerators — if present — or in the community refrigerator.
• Keep a thermometer in the refrigerator and monitor it daily to ensure it stays at 41ºF (5ºC) or below.
• Label the food with the date it was made as well as with the resident’s name and room number. Forgetting to label food is a common mistake food handlers make in nursing homes.
• Discard time-temperate control for safety (TCS) foods within seven days from the date it was made.
• Reheat leftovers to 165ºF (74ºC) for at least 15 seconds. Allow the food to cool before serving.
• Avoid serving raw or undercooked animal foods, unpasteurized soft-cooked eggs or juice, or raw seed sprouts. Learn more about food temperature regulations in nursing homes.

Also, consider food safety for residents on altered-textured diets and whether the food brought in from outside sources is appropriate for their prescribed diet texture.

I’m familiar with at least one incidence where a resident on a soft and bite-sized diet (IDDSI Level 6) had chicken nuggets delivered from a fast food restaurant and the resident ended up choking and passing away since they were larger than what the diet allowed.

Always educate the resident and their family or representative upon admission so they are familiar with your policy.

It’s also a good idea to provide the family or representative with a handout on how to handle and prepare food safely since many people simply don’t know that certain foods or preparation methods could harm their loved ones.

The bottom line

Food brought in from outside sources may be unsafe, so it’s important to have policies and procedures in place that protect your residents.

Educate your resident and their family or representative upon admission so they understand these policies and procedures.

Providing a handout to the family or representative on food safety and which foods are unsafe to serve is also a good way to protect their loved ones.