Failure to Maintain Safe Hot-Holding Temperatures and Document Food Temperatures
Penalty
Summary
The deficiency involves the facility’s failure to maintain safe hot-holding temperatures for food on the steam table and to consistently monitor and document food temperatures as required by facility policy. During a lunch meal service, surveyors observed that the steam table was cool to the touch as food was being placed on it, and an alternate menu item (chili) was placed on the steam table without any temperature being taken. Later in the meal period, the chili showed no visible steam, and review of the Temperature Logbook revealed no documented temperatures for that lunch. After the last resident was served, measured temperatures of several items on the steam table were below the facility’s required hot-holding standard of 140°F, including pureed vegetables at 121.4°F, gravy at 128.0°F, mechanical chicken at 100.5°F, and chili at 118.0°F. The facility’s dietitian stated that staff were expected to take and document temperatures on all items placed on the steam table, acknowledged not being sure of the correct holding temperature until later, and confirmed that the facility policy required hot foods to be held at or above 140°F. Multiple residents were served food from these improperly held items, including residents who received chili and residents on pureed diets. Several residents reported that their food, including chili and other meals, was not hot, describing it as lukewarm, cold, or “hit and miss” in terms of temperature and quality. Grievance forms documented prior complaints from residents about being served cold cheeseburgers, fries, grilled cheese, and tomato soup on previous dates. The facility’s written Food Policy, revised earlier, required staff to check hot foods regularly to ensure they were held at or above 140°F and to maintain recordkeeping through a Final Cooking and Reheating Log and a Food Cold Hot Holding Log for all foods being hot or cold held, which was not followed during the observed meal service.
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