| 71 |
NASHVILLE COMMUNITY CARE & REHABILITATION AT BORDE |
445033 |
1414 COUNTY HOSPITAL RD |
NASHVILLE |
TN |
37218 |
2019-04-03 |
812 |
F |
0 |
1 |
PJC211 |
Based on facility policy review, observation, interview, and review of the Dish Machine Temp (Temperature) Audit, the facility dietary department failed to operate the dish machine according to the manufacturer's recommendation in 1 of 4 observations; and the facility failed to maintain 2 of 4 ice machines and 2 of 3 microwaves in a sanitary manner in 3 of 4 nourishment rooms. The findings include: Review of the facility policy, Dishmachine Procedure, revised on 1/17/19, revealed .Recording of Dishmachine Temperature .Record temperatures every shift on Dishmachine Temperature Log . Observation on 4/1/19 at 9:46 AM in the dietary department dishroom, with the Dietary Manager present, revealed the dishmachine was in operation. Further observation of the posted manufacturer's recommendation revealed the minimum wash temperature was 160 degrees Fahrenheit (F) and the minimum final rinse sanitizing temperature was 180 degrees F. Further observation revealed resident meal trays, plate covers, and plate bases were being processed through the dishmachine with the final sanitizing rinse temperatures of 171, 168, 166, and 160 degrees F. Further observation revealed the resident trays, plate covers and bases were stored after they were removed from the dishmachine. Interview with the Dietary Manager in the dietary department dishroom on 4/1/19 at 10:00 AM when asked who was responsible to take the dishmachine temperatures when it was in operation, the Dietary Manager revealed .I take the temperatures once a week and chart it . When asked who takes and records temperatures the other times, the Dietary Manager revealed the .only temperatures taken and recorded are the ones I get once a week . When asked when was the last time the temperatures were taken, the Dietary Manager revealed .I forgot to do it last week so it was the week before . Further interview revealed the Dietary Manager was not aware the temperatures were to be taken for every operation cycle, morning meal, mid-day meal, evening meal, and any other operation. Review of the Dish Machine Temp Audit form revealed the wash temperature on 1/8/19 and on 3/21/19 was158 degrees F, and on 3/26/19 was 159 degrees F. Further review revealed the final rinse sanitizing temperature on 3/21/19 was 179 degrees F. Interview with Maintenance staff #1 on 4/1/19 at 10:00 AM in the dietary department dish room revealed .over the weekend the boiler broke down and the steam it generates operates the dishwasher and it might not have recovered yet . Interview with the Administrator on 4/2/19 at 12:22 PM in the conference room confirmed the facility policy was not followed related to the failure to document the dish machine temperatures every shift. Observation in the Birmingham building Nourishment Rooms on 4/2/19, with facility staff present, revealed the following: At 3:12 PM on the 4th floor with Licensed Practical Nurse (LPN) #6 present, revealed the interior of the ice machine had pink colored debris on the ice slide. Further observation revealed the interior of the microwave had a very heavy accumulation of multi-colored dried debris and food debris. Interview with LPN #6 in the 4th floor Nourishment Room on 4/2/19 at 3:12 PM confirmed the microwave interior had debris and the ice machine interior had pink color debris. At 3:16 PM on the 3rd floor, with Medical Record staff #1 present, revealed the interior of the microwave had an accumulation of dried food debris. Interview with Medical Record staff #1 in the 3rd floor Nourishment Room on 4/2/19 at 3:16 PM confirmed the microwave interior had debris. At 3:20 PM on the 2nd floor, with Unit Manager #4 present, revealed the interior of the ice machine had pink colored debris on the ice slide. Interview with Unit Manager #4 on 4/2/19 at 3:20 PM in the Nourishment Room confirmed the interior of the ice machine had pink debris. |
2020-09-01 |