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
Kitchen sanitation, food safety, and temperature monitoring 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

The facility failed to keep the kitchen hood clean, removed moldy cantaloupe from storage only after it was observed, allowed a staff drink to be stored in the kitchen freezer, and observed an employee washing hands for only four seconds with visible substance still on the arm before serving food. Food and refrigerator temperature logs were incomplete, and the activities refrigerator was found with condensation, black buildup, and temperatures above the safe range while the AD reported freezer temperatures were not being checked.

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.
Unsanitary Kitchen Food Storage and Handling
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

Unsanitary food handling and storage conditions were observed in the main kitchen. Food was stored under pipes with ice buildup dripping onto items, several meat packages were left unsealed, cereal drawers were open, a foam cleanser sat on a prep table with food, rotten bananas were present, melted butter was left uncovered, a bag of buns touched the floor, and the Dietary Supervisor entered without a hair restraint or beard guard.

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 and Ice Machine 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 items in the walk-in cooler were found with expired use-by dates, missing labels or dates, and signs of spoilage, including discolored lettuce and opened cheese products left improperly stored. Surveyors also observed pink and brown substances on the kitchen ice machine baffle above the ice trough. The Head [NAME] acknowledged the storage issues and that the ice machine needed cleaning, while the DDM and Administrator stated that food labeling, dating, spoilage checks, and ice machine sanitation were expected.

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.
Dishwasher Temperatures Not Monitored
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

Dishwasher temperatures in the main kitchen were not monitored to required levels. The log showed repeated wash and final rinse temps below the required range, and during observation the dish machine again ran below spec, with the wash cycle reaching 143 degrees and then 141 degrees and the rinse cycle reaching 177 degrees before not registering. The dining supervisor and food service unit supervisor both stated staff had not notified them about the low temps, despite staff saying they were supposed to record the readings and report out-of-range temps.

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.
Dishwasher Rinse Cycle Failed to Reach Required Sanitizing Temperature
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

Dishwasher Rinse Cycle Failed to Reach Required Sanitizing Temperature: The facility failed to ensure 1 of 1 dishwasher reached the required high-temp rinse range. During observation, the wash cycle reached 153°F and the final rinse reached 150°F, below the posted 180-195°F requirement. The CD confirmed the machine should reach 180°F, and the temp log showed multiple rinse cycles below 180°F with no indication of correction.

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 Sanitation and Food Labeling 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 Sanitation and Food Labeling Failures: Surveyors observed a fryer, toaster oven, wall behind the dishwashing station, and hot holding trays/cookie sheets with heavy grease and grime buildup. Multiple canned goods, pantry snacks, prepared gravy, and prepared pureed chicken were also found without required use-by or expiration dates. Dietary staff and ADM stated staff were responsible for cleaning, labeling, and dating food items, but several items were left undated and the dietary mgr was unavailable.

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 August 26, 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 🗙

Connection lost — reconnecting… We couldn't reconnect automatically. Please reload the page to continue.