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F0804
E

Failure to Serve Food at Safe and Appetizing Temperatures

Council Bluffs, Iowa Survey Completed on 07-24-2025

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

Surveyors identified that the facility failed to provide food at an appetizing and safe temperature to four residents, as evidenced by resident interviews, staff interviews, observations, and policy review. Multiple residents who ate meals in their rooms reported that their food was often delivered cold, with some stating this occurred several times per week. During a lunch meal service observation, food temperatures on a sample tray were measured and found to be below expected standards, with ham at 105°F, cauliflower at 124.5°F, and sweet potato fries at 109.6°F. Staff acknowledged these temperatures were lower than anticipated, and the Certified Dietary Manager stated that food should be above 130°F, while the Registered Dietitian indicated a point of service temperature of 140°F was needed. The facility's policy and the FDA Food Code require hot foods to be held at 135°F or above to minimize the risk of foodborne illness. Residents affected included individuals with varying levels of cognitive impairment, as indicated by their BIMS scores, and some with significant medical histories such as renal insufficiency, neurogenic bladder, and history of stroke. Residents described the food as cold, tough, dry, and unappetizing, with one resident specifically noting a sandwich was "cold like the icebox" and missing components. The Administrator was unaware of complaints prior to the survey and expressed uncertainty about the required food temperatures and how to address the issue, despite facility policy and regulatory guidance.

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