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F0809
E

Delayed Meal Service Due to Kitchen Equipment Failure

Clayton, North Carolina Survey Completed on 10-30-2025

Penalty

Fine: $255,500
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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 deliver meal trays at regular, consistent, and scheduled times to residents on two of three halls due to a prolonged issue with a broken oven in the kitchen. The 400 Hall, which was scheduled to receive the latest meal carts, experienced repeated delays, with residents sometimes receiving their evening meal after 7:00 PM. Observations confirmed that meal trays arrived late on multiple occasions, and interviews with residents indicated dissatisfaction with the timing of meal deliveries. The 200 Hall also experienced inconsistent meal delivery times, with some residents reporting that dinner was served as late as 7:00 PM. The Dietary Manager and Regional Corporate Dietary Manager confirmed that only one oven was operational for over a month, significantly impacting their ability to prepare and deliver meals on schedule, especially when multiple menu items required baking. Residents involved in the findings were cognitively intact and able to report their experiences. The deficiency was directly linked to the kitchen's inability to meet scheduled meal times due to equipment failure, resulting in late meal service and resident complaints.

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