DHS 134.64(4)(b)1. 1. Modified diets shall be prescribed by the attending physician. The attending physician may delegate to a licensed or certified dietitian the task of prescribing a resident’s diet, including a modified diet, to the extent allowed by law. A modified diet shall be served consistent with that order. A dietitian shall participate in decisions about modified and special diets. A record of the order shall be kept on file.

DHS 134.64(4)(b)2. 2. The modified diet shall be reviewed by the physician and the dietitian on a regularly scheduled basis and adjusted as needed. Modifications may include changes in the type and texture of food.

DHS 134.64(5) (5) Meal service.

DHS 134.64(5)(a) (a) Schedule. The facility shall serve at least 3 meals daily at regular times comparable to normal meal times in the community. No more than 14 hours may elapse between a substantial evening meal and breakfast the following day, and not less than 10 hours may elapse between breakfast and the evening meal of the same day.

DHS 134.64(5)(b) (b) Table service. All meals shall be served in dining rooms unless otherwise required by a physician or by decision of the resident’s interdisciplinary team. The facility shall provide table service in dining rooms for all residents who can and want to eat at a table, including residents in wheelchairs.

DHS 134.64(5)(c) (c) Developmental needs of residents. Dining areas shall be equipped with tables, chairs, eating utensils and dishes to meet the developmental needs of each resident.

DHS 134.64(5)(d) (d) Self-help. There shall be adequate staff and supervision in dining rooms and resident rooms to direct self-help eating procedures and to ensure that each resident receives sufficient and appropriate foods to meet the resident’s needs.

DHS 134.64(5)(e) (e) Re-service. Food served but uneaten shall be discarded unless it is served in the manufacturer’s package which remains unopened and is maintained at a safe temperature.

DHS 134.64(5)(f) (f) Temperature. Food shall be served at proper temperatures but not more than 50ºF. (10ºC.) for cold foods and not less than 120ºF. (49ºC.) for hot foods.

DHS 134.64(5)(g) (g) Snacks. If not prohibited by the resident’s diet or condition, snacks shall be routinely offered to each resident between the evening meal and bedtime. Between-meal snacks shall be planned in advance and shall be consistent with daily nutritional needs.

DHS 134.64(6) (6) Food supplies, preparation and cooking.

DHS 134.64(6)(a) (a) Food supplies. Food shall be obtained from sources that comply with all laws relating to food and food labeling.

DHS 134.64(6)(b) (b) Preparation and cooking. Food shall be cleaned, prepared and cooked using methods that conserve nutritive value, flavor and appearance and prevent food contamination. Food shall be cut, chopped or ground as required for individual residents.

DHS 134.64(7) (7) Sanitation.

DHS 134.64(7)(a) (a) Equipment, utensils and environment.

DHS 134.64(7)(a)1. 1. All equipment, appliances and utensils used in preparation or serving food shall be maintained in a functional, sanitary and safe condition. New and replacement equipment shall meet criteria, if any, established by the national sanitation foundation.

DHS 134.64(7)(a)2. 2. The floors, walls and ceilings of all rooms in which food or drink is stored, prepared or served, or in which utensils are washed or stored, shall be kept clean and in good repair.

DHS 134.64(7)(a)3. 3. All furnishings, table linens, drapes and furniture in rooms in which food is stored, prepared or served, or in which utensils are washed or stored, shall be in good condition and maintained in a clean and sanitary condition.

DHS 134.64 Note Note: Copies of the National Sanitation Foundation’s “Listing of Food Service Equipment” are kept on file and may be consulted in the Department’s Division of Quality Assurance and the Legislative Reference Bureau.

DHS 134.64(7)(b) (b) Storage and handling of food.

DHS 134.64(7)(b)1. 1. Food shall be stored, prepared, distributed and served under sanitary conditions that prevent contamination.

DHS 134.64(7)(b)2. 2. All potentially hazardous food that requires refrigeration to prevent spoilage shall, except when being prepared or served, be kept in a refrigerator which shall have a temperature maintained at or below 40° F. (4° C.).

DHS 134.64 Note Note: See ch. DHS 145 for the requirements for reporting incidents of suspected disease transmitted by food.

DHS 134.64(7)(c) (c) Animals. Animals shall be kept out of areas of the facility where food is prepared, served or stored or where utensils are washed or stored.

DHS 134.64(8) (8) Dishwashing. Whether washed by hand or by mechanical means, all dishes, plates, cups, glasses, pots, pans and utensils shall be cleaned in accordance with accepted procedures, which shall include separate steps for pre-washing, washing, rinsing and sanitizing by means of hot water or chemicals or a combination approved by the department.

DHS 134.64 Note Note: For more detailed information on safe and proper methods of dishwashing, see s. DHS 190.10.

DHS 134.64 History History: Cr. Register, June, 1988, No. 390, eff. 7-1-88; CR 04-053: r. (6) (c) and (7) (a) 4. Register October 2004 No. 586, eff. 11-1-04; 2017 Wis. Act 101: am. (4) (b) 1. Register December 2017 No. 744, eff. 1-1-18.

DHS 134.65 DHS 134.65 Dental services.

DHS 134.65(1) (1) Formal arrangements. The facility shall have a formal written arrangement with dental service providers to provide the dental services required for each resident under this section. The services shall be provided by personnel licensed or certified under ch. 447, Stats.