| 22 |
PERSHING GENERAL HOSPITAL SNF |
295000 |
855 6TH STREET |
LOVELOCK |
NV |
89419 |
2018-02-14 |
812 |
F |
0 |
1 |
OUMW11 |
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to store Mighty Shakes at proper temperature, follow proper hand hygiene, discard expired items and properly label opened food. Findings Include: Expired food items: On [DATE] at 10:35 AM, an opened container of mayonnaise was observed located in a refrigerator at the rear of the kitchen. The facility documented the jar of mayonnaise was opened on [DATE]. No manufacture expiration date could be found on container. The Dietary Manager confirmed no expiration date could be found on the manufactured jar of mayonnaise. A facility policy titled, Frozen, Refrigerated, & Dry Food Shelf Life, documented food shall be used within the recommended expiration periods to ensure food freshness and safety. Foods stored in the refrigerator that have a use by date or best before date will be used by that date, or discarded. The opened or prepared foods without a use by or best before date will be discarded after 7 days of opening. All foods would be checked daily and be discarded. Food labeling: On [DATE] at 10:35 AM, observed in a refrigerator, open containers of juice with no open date on the container. The juice in the refrigerator was Thirster Grape, 46 fluid oz. (ounce), Thirster prune juice, 46 oz., Monarch apple juice, 46 fluid oz., and Monarch cranberry juice, 46 oz. The cook and Dietary Manager verbalized facility does not mark juice containers as the containers are opened because the containers of juice were consumed the same day as they are opened. Proper food temperatures and labeling: On [DATE] at 10:35 AM, observed in a refrigerator, 29 dairy Mighty Shakes, to be stored frozen and a box containing 75 chocolate shakes, with a label of keep frozen on them. The Dietary Manager stated the shakes were removed from the freezer and stored in the refrigerator to defrost 48 hours prior to serving residents. It was observed the refrigerator felt warm to the touch on the bottom shelf. The Dietary Manager verbalized the refrigerator felt cooler on the top of the refrigerator than the bottom, there could be a lack of air flow preventing the refrigerator from maintaining a consistent temperature throughout and the health shake temperatures were not documented prior to serving residents. The cook took the temperature of the chocolate shakes and strawberry banana shakes that were not frozen. The chocolate shakes were at a temperature of 48 degrees Fahrenheit and the strawberry banana shakes had a temperature of 53.6 degrees Fahrenheit. The Dietary Manager verbalized and confirmed the shakes were to be kept frozen. Seven residents received the Mighty Shakes for lunch and less than seven residents for dinner. The Dietary Manager verbalized eight residents were served the Mighty Shake for breakfast on [DATE]. The Dietary Manager checked the temperature of the refrigerator with 3 different thermometers. Each thermometer gauged the temperature of the refrigerator with three different temperatures. The first thermometer read 41 degrees Fahrenheit the second thermometer read 46 degrees Fahrenheit and the third thermometer read 40 degrees Fahrenheit. The Dietary Manager explained the shakes would be thrown away prior to serving lunch at the facility on [DATE]. Further, the Dietary Manager would put a ticket in with maintenance to fix the refrigerator. The temperature log for the refrigerator was last documented on [DATE] with a temperature of 38 degrees Fahrenheit. No other temperatures were taken after [DATE], until [DATE]. The DM confirmed this finding. On [DATE] at 12:06 PM, during lunch preparation, it was observed there were 99 shake containers in the refrigerator. The cook confirmed the shakes in the refrigerator were the same shakes observed in the refrigerator a few hours prior. On [DATE], in the afternoon, a blue cooler was observed in the dining area. The cooler was accessible by all residents. Inside the cooler were chocolate Mighty shakes, milk, juice and a small amount of ice in the bottom. On [DATE] at 12:01 PM, the cook expressed maintenance looked at the refrigerator that contained the Mighty shakes. The cook was not aware if the refrigerator was fixed. On [DATE] at 12:31 PM, the DM explained the coils were cleaned on the refrigerator and the Mighty shakes were moved to a different refrigerator. A facility policy titled, Refrigerator Temperature, documented the temperatures in all refrigerators would be taken two times daily and as needed to ensure optimal temperatures were maintained during all phases of food storage, food for patient/resident consumption shall have the temperatures checked twice a day, refrigerator temperature should be between 31 degrees Fahrenheit and 41 degrees Fahrenheit, if the temperature is above 41 degrees Fahrenheit, all foods would be immediately moved to another refrigerator until the problem was corrected, the temperature of the refrigerator would be rechecked after 3 hours. If the temperature was still not within range, a maintenance request would be completed, temperature check and maintenance procedure would be documented on the refrigerator maintenance log. Improper hand hygiene: On [DATE] at 12:06 PM, a Certified Nurse Aid (CNA) was observed entering the kitchen and did not wash her hands. The CNA walked to a refrigerator and took 2 Mighty chocolate shakes out. The CNA was also observed prepping food with no gloves. The CNA confirmed training by the facility indicated to wash hands and glove upon entry to the kitchen. On [DATE] at 12:12 PM, the CNA was observed entering the kitchen and touching tray food covers before washing hands. A facility policy titled, Dietary Handwashing, documented proper hand washing would be used by all dietary employees to prevent the spread of infectious diseases to other staff members and patients. Hands should be washed when coming on duty, after adjusting hair net, and whenever moving from the food preparation area to the food service area. |
2020-09-01 |