Failure to Maintain Safe and Appetizing Food Temperatures
Penalty
Summary
The facility failed to provide food and drink at safe and appetizing temperatures, as required by policy and federal regulations. Facility policy specified that hot foods must be held at 140°F or above and cold foods at 45°F or below, and USDA guidance indicated poultry should reach 165°F and be held at 140°F or higher. Multiple residents reported that their meals were consistently cold, especially when delivered to their rooms, and that staff refused to reheat the food. Residents stated they chose to eat in the dining room to avoid cold food. In a confidential group interview, all participating residents reported that meals were consistently late and cold. Resident council minutes from two meetings also reflected concerns about meal temperatures. Surveyors observed breakfast service with metal kitchen carts left open between tray removals, with several trays remaining inside, and additional trays placed on a cooling rack in a hallway. Staff members acknowledged they were unaware that cart doors needed to be kept closed between removing trays. During a lunch observation, food on the tray line initially met or exceeded hot-holding temperatures for some items, but a test tray obtained when the last tray was delivered showed the sliced turkey at 48°F, mashed potatoes with gravy at 55.8°F, and diced carrots at 51°F. Although the food was described as palatable and visually attractive, it was not at an appealing or appetizing temperature. The acting Dietary Manager confirmed the low temperatures and reported that the facility had only one small insulated cart and two uninsulated metal carts for meal delivery. The Nursing Home Administrator confirmed the facility failed to provide residents with food at a safe and appetizing temperature.
Plan Of Correction
The facility will provide the residents with food and drink that is at safe and appetizing temperatures The tray line will be moved to the kitchen from the dining room to improve efficiency of meal production and improve meal temperatures. Equipment consisting of Thermal Pellet base/heating element and Thermal Dome will be purchased to add additional heated time to the food from the time the meal is planned until delivered to the resident. Ancillary staff as Activities Aide, Medical Records Clerk, Business office assistant will be utilized to assist with tray pass. The Nursing and Dietary staff will be educated by the Administrator/Designee on new process of tray line and meal delivery to the residents and that during meal delivery the cart door must remain closed when not in use. Audits will be completed by the Administrator/Designee on providing the residents with food and drink that is safe and appetizing temperatures. The last tray served will have food temperatures taken to provide safe and appetizing temperatures three times a week at different meal times and then weekly ongoing Results of these audits will be presented to the QAPI committee for review and recommendations
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