Improper Puree Preparation and Inadequate Hot Holding Temperatures
Penalty
Summary
The deficiency involves failure to properly prepare pureed foods according to facility policy and standardized recipes, and failure to maintain appropriate hot holding temperatures for multiple menu items. During observation, a cook pureed beef pot roast and carrots for seven residents on pureed diets by adding unmeasured amounts of hot water to the food processor until the desired consistency was reached, then adding a small scoop of juice from the main roasting pan. The Dietary Manager stated that staff used water as a thinning agent during pureeing and then added a small amount of juice afterward, despite the written recipe for beef pot roast directing staff to count and measure portions and to use juice, milk, or broth as needed to achieve the desired consistency. The facility’s pureed food preparation policy required use of standardized recipes, specified that milk, broth, soup, gravy, and margarine be used to thin pureed food instead of water (unless water was mixed with a thickening agent), and required that pureed hot items be prepared while maintaining a temperature above 135°F. The deficiency also includes failure to maintain and verify safe and appetizing food temperatures during meal service. One resident reported that meals in the second-floor dining room were not always hot, and three resident council members reported that food served during meal services was cold. When surveyors requested food temperatures in the second-floor dining room during a lunch service, the staff member present did not have a food thermometer available in the serving area and had to obtain one from the main kitchen, by which time meal service had already started. Temperature checks then showed pureed carrots at 128°F, pureed beef pot roast at 103°F, and hamburgers at 119°F, all below the facility’s policy requirement that hot foods be held at 135°F or above throughout service. The Dietary Manager confirmed that these items were not at appropriate holding temperatures and could not be served, contrary to the facility’s food temperature policy and applicable Indiana Administrative Code requirements.
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