Nursing Home News

Nursing Homes: CMS Revises Guidance on Undercooked Eggs (Evvie Munley, LeadingAge) – Skilled nursing and nursing facilities should use pasteurized shell eggs or liquid pasteurized eggs to eliminate the risk of residents contracting Salmonella Enteritidis (SE), according to a new revisions to "Sanitary Conditions, Preparation of Eggs in Nursing Homes" released by the Centers for Medicare and Medicaid Services (CMS).

Please read the full CMS memorandum here.

The revisions are consistent with the current U.S. Food and Drug Administration's (FDA) Food Code and Centers for Disease Control and Prevention's (CDC) food safety guidance for procuring, storing, preparing, distributing, and serving food in a safe and sanitary manner.

Egg Preparation

In its letter, CMS clarifies the policy on the acceptability of nursing homes serving soft-cooked, undercooked or sunny-side up eggs to residents. CMS recognizes the FDA's Food Code and the CDC's food safety guidance as national standards to procure, store, prepare, distribute and serve food in a safe and sanitary manner.

While honoring resident requests for soft cooked or sunny side up eggs is an appropriate practice as outlined in §483.15(b) Self Determination and Participation, the CDC and the FDA strongly advise against serving unpasteurized, undercooked eggs to highly susceptible populations which includes elders and persons residing in LTC facilities. The FDA Food Code advises that eggs prepared and served to persons in nursing homes should be pasteurized or cooked until both the yolk and whites are firm.

Nursing homes can honor resident choice while maintaining health and safety standards through the use of pasteurized eggs. If a facility uses unpasteurized shell eggs for individual resident consumption, those eggs must be cooked until both the yolk and white are completely firm and served immediately.

For all other forms of egg preparation, including hot holding of eggs, and pooling (combining) for recipes where more than one egg is broken and the eggs are pooled and used as an ingredient immediately before baking, e.g., a meat loaf mixture, muffins or cake, the eggs must be pasteurized or thoroughly cooked to an internal temperature of 160°F (71°C).

Can Residents Sign a Waiver for Undercooked, Unpasteurized Eggs?

CMS is aware of nursing homes having secured signed health release agreements from residents/representative requesting undercooked eggs.

The use of agreements between the resident/representative and the facility acknowledging the resident's acceptance of the risk of eating undercooked unpasteurized eggs is prohibited.

If a facility serves soft-cooked, undercooked or sunny-side up unpasteurized eggs, surveyors should determine the appropriate scope and severity based upon negative actual and potential outcomes and in accordance with guidance at F371.

ICD-10 Provider Workshops for Areas 3A and Area 11 – The Florida Agency for Health Care Administration (AHCA) has announced ICD-10 Provider Workshops for Areas 3A and 11.

This workshop is designed for providers that are currently required to bill Florida Medicaid with ICD-9 codes and will have to implement the ICD-10 codes. All providers are encouraged to attend. Please note, this is not an ICD-10 coding class.

Below is a list of the Area workshops:

• Area 3A (Alachua, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Levy, Lafayette, Putnam, Suwanee, Union) – Wednesday, June 25th at 9:00 a.m. at the Area 3A Medicaid Office located at 14101 NW Highway 441, Suite 600, Alachua.
• Area 11 (Miami-Dade, Monroe) – Thursday, June 26th at 9:00 a.m. and 11:00 a.m. at the Area 11 Medicaid Office located at 8333 Northwest 53rd Street, Suite 200, Doral.

To Register for a training session, please click here. Scroll down to the link for your Area’s Provider Training Calendar for instructions on how to register.

AHCA Schedules a Rule Development Workshop – The Agency for Health Care Administration (AHCA) has scheduled a rule development workshop for the purpose of discussing the Certification of Need requirements for Nursing Facility Beds as well as language associated with these facilities in Certificate of Need rules.

The meeting will take place on Tuesday, July 1 at 10 a.m. at the Agency for Health Care Administration, Building 3, Conference Room C at 2727 Mahan Drive in Tallahassee.

For more information or for copies of the agenda, please contact Marisol Fitch via email or by phone at (850) 412-3750.