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CMS Revises Guidance to F-371 about Preparation of Eggs

After last year’s landmark case about runny eggs, Elgin, CMS has finally issued guidance on the appropriate preparation of eggs in nursing homes in a S&C letter dated May 20, 2014, “Advance Copy of Revised F371; Interpretive guidance and Procedures for Sanitary Conditions, Preparation of Eggs in Nursing Homes.” The guidance notes:

  • Nursing homes should use pasteurized shell eggs or liquid pasteurized eggs to eliminate the risk of residents contracting Salmonella. Using pasteurized eggs allows for resident preference for soft-cooked, undercooked or sunny-side up eggs while maintaining food safety. In accordance with CDC and FDA standards, these facilities should not use unpasteurized eggs for these types of requests. If the facility uses unpasteurized shell eggs for individual resident consumption, the 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 and pooling, the eggs must be pasteurized or thoroughly cooked to an internal temperature of 160°F (71°C)
  • Signed health release agreements from residents/representatives requesting undercooked eggs are not acceptable.
  • Scope and Severity of an immediate jeopardy level will be assessed through surveyor review of evidence about the resident’s immediate risk of serious injury, harm, impairment or death, the number of residents that were affected, food preparation and meals and other systems failures that could lead to a food-borne illness and surveyor observations about egg availability.

This is effective immediately. Read the S&C letter on the CMS website.

See our June 2013 article that includes information about citations at F-371, including the Elgin case.