Healthcare CMS – F371

Davidson's Safest Choice® pasteurized shell eggs are specified by rigorous food safety standards such as the FDA Food Code and CMS F371 revision released May 20, 2014.

Pasteurized Eggs in LTC: CMS F371

The CMS F371 memo states the following Guidance for nursing homes:

“Skilled nursing and nursing facilities should use pasteurized shell eggs or liquid pasteurized eggs to eliminate the risk of residents contracting Salmonella Enteritidis (SE). The use of pasteurized eggs allows for resident preference for soft-cooked, undercooked or sunny-side up eggs while maintaining food safety. In accordance with the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) standards, skilled nursing and nursing facilities should not prepare nor serve soft-cooked, undercooked or sunny-side up eggs from unpasteurized eggs.”

Health releases for undercooked eggs – CMS F371

A common question in long-term care is whether it is acceptable to serve an ordinary shell egg undercooked if there is a health release on record. The CMS Interpretive Guidance memo says no: “CMS is aware of facilities having secured signed health release agreements from residents (or the resident’s representative) requesting to be served undercooked eggs. Health release agreements allowing soft-cooked, undercooked or sunny-side up unpasteurized eggs for resident preference are not acceptable.”

LTC Nursing facilities: Why pasteurized eggs?

CMS, in the CMS Interpretive Guidance and Procedures memo, explains why it specifies pasteurized eggs in skilled nursing and nursing facilities: “The Centers for Medicare & Medicaid Services (CMS) is clarifying the acceptability of longterm care (LTC) facilities serving soft-cooked, undercooked or sunny-side up eggs to their residents. CMS recognizes the U.S. Food and Drug Administration’s (FDA) Food Code and the Centers for Disease Control and Prevention’s (CDC) food safety guidance as national standards to procure, store, prepare, distribute and serve food in a safe and sanitary manner. Therefore, 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, however 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. Specifically, CDC literature states, “Although anyone can get a Salmonella infection, older adults, infants and people with impaired immune systems are at increased risk for serious illness. In these people, a relatively small number of Salmonella bacteria can cause severe illness.”

The CDC states, ‘A person who eats eggs can lower the risk of SE infection by eating eggs that are thoroughly cooked, or by eating foods that are made from pasteurized eggs’. CMS agrees with the FDA and CDC’s guidance against serving unpasteurized, undercooked eggs to LTC facility residents.”

More info about pasteurized eggs for nursing facilities in LTC:

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FDA Food Code Explains Egg Safety & Pasteurized Eggs

The FDA, in its 2013 Food Code, identifies "inadequate cooking, such as undercooking raw shell eggs" as one of the top five contributors to foodborne illness in foodservice. Read more in the Davidson's Safest Choice® Foodservice blog >