F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F

Unsafe Food Storage, Equipment Sanitation, and Improper Hot Food Holding

Puxico Nursing And Rehabilitation CenterPuxico, Missouri Survey Completed on 11-17-2025

Summary

Food was stored and served under unsanitary conditions in the kitchen and food service area. On observation, surveyors found dented cans of mixed fruit, spaghetti sauce, and green beans that had been received and kept in storage, along with four clear plastic cereal containers that were unlabeled and undated. An approximate 10-gallon container of cornmeal was loosely covered, undated, and mislabeled as fish, and another 10-gallon container of sugar was loosely covered and undated. The kitchen also had a nonfunctioning plate warmer with a damaged electrical cord, an ice machine with grime and debris buildup, a dishwasher with grime buildup, a gas range with oily grime and food debris, dusty ceiling diffusers, and a commercial can opener with an oily film and grime buildup. The 3-compartment sink hot water faucet measured 88 F, and there was no cleaning log. During meal service, a dietary aide dipped food from steam table trays onto room temperature plates. The steam table held ground roast beef at 115 F and gravy at 80 F. A test tray observed later showed a plate cool to the touch, sliced ham at 108 F, spinach at 110 F, diced potatoes at 104 F, and roast beef at 115 F. A resident stated that food was sometimes cold when received in the dining room. The dietary aide said the plate warmer had not worked during the four months he or she had worked at the facility and had not been used. The dietary manager stated the steam table food temperatures should have been around 165 F and that the gravy was probably warmed in the microwave but not heated enough. The dietary manager also stated the food should have been warmer on the steam table, the bins should have been labeled, the dented cans should have been discarded or placed on a dented can shelf, the ice machine and drainpipes should have been clean, the air vents should have been kept clean, the can opener was damaged and dirty, and there had been no cleaning logs for dietary staff. The administrator and DON stated the kitchen should have been run according to facility policy and regulations, that more deep cleaning was needed, and that hot meals should not be served cool.

Penalty

No penalty information released
tooltip icon
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.

Resources

Below are regulatory guidelines relevant to this citation:

See other F0812 citations
Unsafe Food Storage and Dishwashing Practices
F
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Unsafe Food Storage and Dishwashing Practices: Surveyors observed dented cans in dry storage, a walk-in freezer at 10 F with ice cream, buns, and popsicles soft or showing signs of melt/refreeze, and a handwashing sink trash can that required hand contact to open. Staff were seen carrying used paper towels across the kitchen to overflowing trash cans, and a Dishwasher moved between dirty and clean dish tasks, handled cigarettes in a puddle, and unloaded clean items without changing gloves or performing hand hygiene. The DON/Administrator and Dietary leadership acknowledged the concerns during interview.

No penalty information released
tooltip icon
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.
Kitchen Food Storage and Sanitation Failures
E
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Kitchen staff failed to follow food storage and sanitation standards when unlabeled, undated food items were found in the walk-in freezer and refrigerator, an uncovered garbage can was observed next to the prep table, and a DC was not wearing a hair restraint over his mustache area. Staff interviews confirmed that labeling, dating, covering the garbage can, and wearing hair restraints were expected responsibilities, and facility policies required covered, labeled, and dated refrigerated and frozen foods as well as proper personal cleanliness in food prep areas.

No penalty information released
tooltip icon
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.
Food Storage, Labeling, and Hand Hygiene Failures
F
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Food storage, labeling, and sanitation practices were not followed in the kitchen. Sanitizer buckets tested outside the manufacturer range, numerous prepared and packaged foods were found unlabeled, missing open or use-by dates, or expired across multiple storage areas, and a cook handled raw chicken with contaminated gloves after touching a speaker without removing the gloves or performing hand hygiene.

No penalty information released
tooltip icon
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.
Improper Hair Restraints During Food Preparation and Service
E
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Improper Hair Restraints During Food Preparation and Service: Kitchen staff were observed serving and preparing meals without properly covering all hair. One staff member wore a beanie that left braids uncovered while assisting with the noon meal, and another wore a headband with hair uncovered while preparing the noon meal. Interviews confirmed staff understood hair restraints were required to keep hair out of food, and the facility policy required all employees in food prep areas to wear a hairnet or hair covering.

No penalty information released
tooltip icon
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.
Unsafe Food Storage in Kitchen and Nourishment Room Freezer
D
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Unsafe food storage was identified in the main kitchen and in 1 of 2 nourishment rooms. The walk-in freezer had no stand-alone thermometer, and the 300 Hall nourishment room freezer registered 30 degrees Fahrenheit with 7 thawed ice cream bars stored inside. The Kitchen Manager acknowledged the missing thermometer and confirmed the thawed items.

No penalty information released
tooltip icon
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.
Food Storage, Labeling, and Kitchen Sanitation Deficiencies
F
F0812 F812: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Short Summary

Food storage, labeling, and sanitation deficiencies were observed in the kitchen and a serving kitchenette. Undated and unlabeled food items were found in refrigerators and freezers, milk was present past its best-by date, food debris and sticky residue were noted in freezer areas, a ceiling vent was dirty, and cooks with beards were observed without beard nets. The DD verified the findings, and staff stated items past date should be discarded and food items should be labeled and dated when stored.

No penalty information released
tooltip icon
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.
Citation search

Search every citation & Plan of Correction

Go to search
Citation watch

Track new serious citations across Missouri

Get a heads-up on the newest immediate-jeopardy (J–L) citations in Missouri — where surveyors are focused right now.

Free · about one email a month

Trusted data from CMS and state health departments

Every citation, penalty and Plan of Correction is sourced from public CMS records (latest release July 29, 2026) and official state health department websites — never guesswork.

In your survey window? See what surveyors are citing.

The Survey-Prep Report maps your facility's risk from 12 months of CMS and state citation data — what's being cited around you and what to check first. $129 one-time.

Get the Survey-Prep Report
An unhandled error has occurred. Reload 🗙