Nursing Investigation Results -

Pennsylvania Department of Health
CAMBRIA CARE CENTER
Patient Care Inspection Results

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Severity Designations


Minimal Citation - No Harm	Minimal Harm	Actual Harm	Serious Harm

CAMBRIA CARE CENTER
Inspection Results For:
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CAMBRIA CARE CENTER - Inspection Results	Scope of Citation Number of Residents Affected By Deficient Practice

Initial comments:

Based on a complaint survey completed on September 23, 2019, it was determined that Cambria Care Center was not in compliance with the following requirements of 42 CFR Part 483, Subpart B, Requirements for Long Term Care Facilities and the 28 Pa. Code, Commonwealth of Pennsylvania Long Term Care Licensure Regulations.

Plan of Correction:

483.60(i)(1)(2) REQUIREMENT Food Procurement,Store/Prepare/Serve-Sanitary:

This is a less serious (but not lowest level) deficiency and affects more than a limited number of residents, staff, or occurrences. This deficiency is one that results in minimal discomfort to the resident or has the potential (not yet realized) to negatively affect the resident's ability to achieve his/her highest functional status. This deficiency was not found to be throughout this facility.

�483.60(i) Food safety requirements.
The facility must -

�483.60(i)(1) - Procure food from sources approved or considered satisfactory by federal, state or local authorities.
(i) This may include food items obtained directly from local producers, subject to applicable State and local laws or regulations.
(ii) This provision does not prohibit or prevent facilities from using produce grown in facility gardens, subject to compliance with applicable safe growing and food-handling practices.
(iii) This provision does not preclude residents from consuming foods not procured by the facility.

�483.60(i)(2) - Store, prepare, distribute and serve food in accordance with professional standards for food service safety.

Observations:

Based on review of policies, as well as observations and staff interviews, it was determined that the facility failed to store food in accordance with professional standards for food safety in three of four nursing unit pantries (second, third and fourth floors).

Findings include:

The facility's policy regarding labeling foods, revised July 17, 2019, revealed that all foods items were to be dated when they were opened and when purchased foods were removed from their original container or packaging.

Observations in the drawers and cabinets in the second floor nursing unit pantry on September 23, 2019, at 4:05 p.m. revealed that a previously opened can of powdered thickener, and five bowls of cereal that were out of their original packaging, were not labeled with the date they were opened. Interview with Licensed Practical Nurse 1 on September 23, 2019, at 4:10 p.m. confirmed that the can of powdered thickener and bowls of cereal were not labeled with the date they were opened and should have been.

Observations in the drawers and refrigerator in the third floor nursing unit pantry on September 23, 2019, at 4:15 p.m. revealed that a previously opened half-gallon of milk and five bowls of cereal that were out of their original packaging were not labeled with the date they were opened. Interview with Registered Nurse 2 on September 23, 2019, at 4:17 p.m. confirmed that the milk and bowls of cereal were not labeled with the date they were opened and should have been.

Observations in the drawers in the fourth floor nursing unit pantry on September 23, 2019, at 4:20 p.m. revealed that two bowls of cereal that were out of their original packaging were not labeled with the date they were opened. Interview with Licensed Practical Nurse 3 on September 23, 2019, at 4: 22 p.m. confirmed that the bowls of cereal were not labeled with the date they were opened and should have been.

Interview with the Dietary Director on September 23, 2019, at 6:00 p.m. confirmed that the items listed above should have been labeled with the date they were opened.

42 CFR 483.60(i)(1)(2) Food Procurement, Store/Prepare/Serve-Sanitary.

Previously cited 4/25/19.

28 Pa. Code 211.6(f) Dietary services.

Previously cited 4/25/19.

Plan of Correction - To be completed: 10/18/2019

Plan of Correction:
The following is submitted for plan of correction purposes only and should not be construed as an admission.
Food items stored in the unit pantries were inspected to ensure that the food packaging was labeled with the date it was opened, as well as, to ensure food items were discarded by the "use by" date, per policy. Food items that did not meet these requirements were discarded. Bowls of cereal, were replaced with cereal in original packaging with discard after date identified. Bulk milk and juice items were also replaced with individual serving of these items in original packaging. Thickener will be provided to nursing units by Dietary and will be placed in a container which shall be labeled with date of opening and expiration, as well as content labels.
Residents are receiving food items from the unit pantries that are labeled/dated properly per policy.
The Director of Nursing/Designee will in-service the dietary and nursing staff on food safety requirements. The education will include a review of the facility's policy on labeling and dating food items, as well as, a review of federal regulation F812.
The Director of Nursing/Designee will perform audits to ensure food items are properly labeled and dated according to policy: daily X 2 weeks, then weekly X 2 months, then monthly X 2 months. A dietary staff member will check refrigerators and freezers daily for compliance and initial a log that this was done as well.
Results of the audits will be forwarded to the Quality Assurance Performance Improvement Committee for review and recommendations.

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