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F0804
E

Failure to Serve Food at Safe and Appetizing Temperatures

Indianapolis, Indiana Survey Completed on 05-21-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to ensure that food and drink were served at safe and appetizing temperatures, resulting in multiple residents receiving cold or unpalatable meals. Observations revealed that residents who ate in their rooms frequently received food that was cold by the time it reached them, with some residents reporting that staff would not reheat their meals due to the lack of accessible microwaves. Several residents indicated that their food was often cold, and some left meals uneaten or sought food outside the facility as a result. Trays were observed sitting in hallways for extended periods before being distributed, and the plastic coverings intended to maintain temperature were sometimes removed prematurely. Dietary staff attempted to keep food warm using plate warmers and heated plates, but these measures were insufficient, as food lost heat quickly after plating. The facility relied on open metal carts for food transport, and delays in tray delivery by nursing staff further contributed to the problem. Residents also reported not always receiving the food they ordered, not being offered alternative menu options, and not always being served the prescribed diet. Resident council minutes and grievance logs documented ongoing complaints about cold food, limited choices, and poor food quality over several months. Interviews with dietary and administrative staff confirmed awareness of the issue, with acknowledgment that heated transport carts had only recently been approved and would not be available for some time. In the interim, there were no additional measures from the kitchen to keep food hot, and the process for timely meal delivery was inconsistently followed. The facility's own policy required food to be served at acceptable temperatures, but observations and resident feedback indicated this standard was not being met.

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