§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.
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Observations:
Based on facility policy review, observations, review of select facility temperature logs, and staff interviews, it was determined that the facility failed to store food and utilize equipment in accordance with professional standards for food service safety in the main kitchen and two of two nourishment areas.
Findings include:
Review of facility policy, titled "Food Storage" last reviewed April 4, 2025, read, in part, "Food will be purchased in quantities that can be stored properly and arranged in food groups for organized storage and inventory. All stock must be rotated with each new order received. Food should be dated as it is placed on the shelves if required by state regulation. All containers or storage bags must be legible and accurately labeled and dated. Scoops should be kept covered in a protected area near the containers rather than in the containers. Thermometers should be checked at least two times each day. Refrigerators/freezers on nursing units should be supplied with thermometers and monitored for appropriate temperatures. All foods should be covered, labeled and dated routinely monitored to assure that foods (including leftovers) will be consumed by their use by dates, or frozen (where applicable) or discarded."
Observation in the main kitchen on May 12, 2025, at 9:25 AM, revealed one bin of brown sugar not labeled or dated, and one bin of white sugar dated "9-19."
Interview with Employee 1 (Dietary Manager) on May 12, 2025, at 9:27 AM, revealed the brown sugar should be labeled and dated, and the white sugar had been replenished since September 19, 2024. Observation in walk-in freezer unit on May 12, 2025, at 9:30 AM, revealed four packs of succotash vegetables not dated, and one appeared to be freezer burned; and one box of green beans with the packaging unwrapped and left open to air.
Observation in the dry storage area on May 12, 2025, at 9:41 AM, revealed three packages of hot dog buns with a best by date of May 3, 2025; one package of hot dog buns with a best by date of May 7, 2025; three boxes of fudge round cookies not dated; seven boxes of oatmeal cookies not dated; six bags of devil's food cake mix not dated; and seven bags of fudge brownie mix not dated.
Observation in the 2nd Floor pantry area on May 12, 2025, at 9:49 AM, revealed refrigerator and freezer temperatures were missing from the May 2025 temperature log on May 2-5, 10, and 11, 2025.
Further observation in the 2nd Floor pantry area on May 12, 2025, at 9:50 AM, revealed one bag of Texas toast not dated; and a bin of individual snacks containing oatmeal cookies, fudge round cookies, and fig cookies not dated.
Observation in the 2nd Floor pantry area refrigerator on May 12, 2025, at 9:51 AM, revealed two cartons of fat free milk with a sell by date of May 9, 2025.
Observation in the 3rd Floor pantry area on May 12, 2025, at 9:56 AM, revealed refrigerator and freezer temperatures were missing from the temperature log on May 2-11, 2025.
Further observation in the 3rd Floor pantry area on May 12, 2025, at 9:57 AM, revealed half of a loaf of Texas toast not dated; three containers of corn flake cereal not dated; and a bin of individual snacks containing oatmeal cookies, fudge round cookies, and fig cookies not dated.
Observation in the 3rd Floor pantry area refrigerator on May 12, 2025, at 9:58 AM, revealed a container of two open vanilla puddings in the refrigerator labeled "medication pass."
Interview with Employee 1 on May 12, 2025, at 9:59 AM, revealed she has had numerous conversations with nursing staff that they are not to leave open puddings in the refrigerator that are left over from medication pass.
Follow-up visit in the 3rd Floor nourishment area on May 13, 2025, at 12:37 PM, revealed refrigerator and freezer temperatures failed to be logged on May 12, 2025, in AM and PM.
Follow-up visit in the 2nd Floor nourishment area on May 13, 2025, at 12:44 PM, revealed refrigerator and freezer temperatures failed to be logged on May 12, 2025, in AM and PM; and revealed one container of thickening powder labeled with two different open dates of May 9, 2025, and May 12, 2025, that was open with a scoop stored inside.
Review of select facility temperature logs provided revealed the facility was unable to provide kitchen equipment temperature logs for the dish machine, reach in three-door refrigerator, kitchen walk-in refrigerator and freezer, or 2nd and 3rd floor nourishment areas from November 2024, December 2024, and January 2025.
Review of the February 2025 2nd Floor pantry area nourishment room temperature log, revealed refrigerator temperatures failed to be recorded on February 21-27 in AM, and February 15-28 in PM; and revealed freezer temperatures failed to be recorded on February 15-28, 2025, in AM and PM.
Review of the February 2025 3rd Floor pantry area nourishment room temperature log, revealed refrigerator and freezer temperatures failed to be recorded on February 9-28, 2025, in AM and PM.
Review of the April 2025 2nd Floor pantry area nourishment room temperature log, revealed refrigerator and freezer temperatures failed to be recorded on April 17-23, 25, and 27-30 in AM; refrigerator temperatures failed to be recorded on April 20-23, 25, and 27-30 in PM; and freezer temperatures failed to be recorded on April 23, 25, and 27-30 in PM.
Interview with the Nursing Home Administrator on May 14, 2025, at 10:17 AM, revealed it was the facility's expectation that expired items are discarded, foods items are labeled and dated per facility policy, and food items and kitchen equipment are stored, monitored, and utilized in accordance with professional standards.
28 Pa. Code 211.6(f) Dietary services 28 Pa. Code 211.12(d)(3) Nursing services
| | Plan of Correction - To be completed: 06/25/2025
Facility cannot retroactivity correct areas identified regarding food storage and facility temperatures.
Facility immediately disposed of and replaced the brown sugar and white sugar and ensured these were dated according to policy. All non-dated/unwrapped vegetables were immediately disposed of. All items in the freezer were checked to ensure appropriate labels/dates were in place as well as items covered/wrapped/sealed appropriately. Hot dog buns in dry storage were disposed of. All items in dry storage were immediately checked to ensure dating is occurring in accordance with facility policy.
2nd and 3rd floor nourishment rooms have been inspected to ensure all items are labeled and dated in accordance with facility policy.
Facility food storage/labeling/dating policies have been reviewed to ensure they meet the regulation. New temperature logs have been implemented in the main kitchen as well as 2nd and 3rd floor nourishment rooms.
All dietary staff will be in serviced on the facility storage/temperature policies and the new logs to ensure compliance. Nursing staff and managers will be in serviced on dating/labeling & equipment temperatures for 2nd and 3rd floor nourishment rooms.
Food Service Manager or designee will audit temperature logs/labeling/dating weekly for the next 3 months and monthly thereafter.
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