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

Uncontrolled Fly Infestation and Poor Kitchen Maintenance Affecting Food Sanitation

Nick's Health Care CenterPlattsburg, Missouri Survey Completed on 10-03-2025

Summary

Surveyors identified a deficiency in sanitary food service conditions when the facility failed to control a persistent fly problem in the kitchen and dining areas and did not maintain kitchen surfaces, flooring, and doors in good repair. Observations showed flies in the kitchen landing on peaches in bowls and on salads being prepped, as well as clusters of flies on all surfaces and on food being prepared and served. Dead flies were seen on the floors by all prep areas and on a fly sticky strip hanging in the kitchen bathroom with the door open. The wall behind the cook stove had a section of the corner pushed in with missing drywall, and the kitchen flooring at the serving line was peeling away from the floor, with caked-on debris lodged between the laminate and the concrete, creating an area that could not be adequately cleaned. The back delivery door to the kitchen was lopsided in the frame, leaving a 1.5–2 inch gap that allowed flies and insects to enter the kitchen. The Dietary Manager reported being aware for about a week that the wall behind the stove was falling in but had not reported it to maintenance, and also knew the flooring by the serving line had been steadily coming up and was hard to keep clean, yet had not reported the floor issues. The Dietary Manager stated the exit door did not fit correctly, believed this was the main reason for the fly problem, and acknowledged the issue had been reported to maintenance at some point but had not submitted a new work order. A staff member stated flies were always a problem in the kitchen and that they were constantly swatting flies off food and prep areas, describing the fly problem as ongoing despite fly traps and exterminator involvement. Two residents reported that flies while eating were “ridiculous,” annoying, and that they did not like flies landing on their food or touching their faces while they tried to eat. The Maintenance Director, who had started two weeks prior, was unaware of the wall, floor, or door issues but acknowledged a fly problem, especially in the kitchen and dining room. The Administrator was aware of the fly problem and the misaligned kitchen door but was unaware of the wall and flooring issues, and stated residents have the right to live in a home without flies continually landing on them and their food.

Penalty

Inspection fine: $21,948
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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.

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
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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.
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.
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