Ivy Hill Rehabilitation And Nursing Center (June 13th)
Based on observations made during the initial environmental tour of the kitchen, observations made during the noon meal service on the second floor nursing unit, interviews with the dietary manager, group interview with residents, review of dietary policies and procedures for holding cold foods and reviews of pest control operator’s reports, it was determined that the nursing home failed to follow proper sanitation and food handling practices. Findings included the following: Observations at 9:30 a.m. on June 10, 2013 revealed that the closed double doors that were located near the dietary department and and lead directly outside the facility to the garage and refuse area contained an air gap at the threshold of the doorway. The opening provided easy access for household pets. Flies were noted in the kitchen and hallway outside of the kitchen. The pest control operator’s reports for the month of May 2013 revealed that the kitchen was receiving pest prevention services weekly for common household pests. Interview with a group of alert and oriented residents on June 11, 2013 revealed that several residents were not satisfied with the temperature of the foods, at the point of service, from the dietary department.
Observations during of the noon meal dietary service, on June 12, 2013 for the residents of the Philadelphia nursing unit, revealed that all cold food items were not being held cold before distribution and service. Small cartons of unopened milk were observed and placed on ice in a metal container on a mobile cart for distribution to the residents. Eighteen pre-portioned uncovered dishes of vanilla and chocolate pudding, one dozen tuna fish and cheese sandwiches covered in plastic and pre-portioned four ounce cranberry juices were held underneath the steam table or on a small opened mobile cart; without the use of cold food holding equipment/devices. In an interview with Employee E3, dietary manager on June 12, 2013, it was revealed that there were no temperature logs (records) of the hot or cold foods that were being served for the noon meal, on the second floor nursing unit.
A review of the nursing home’s dietary policy for hot and cold holding temperatures indicated that when holding foods for service, such as the buffet line, always remember to keep hot foods hot and cold foods cold. Hot-holding equipment must be able to keep foods at a temperature of 135 degrees fahrenheit or higher and cold holding equipment must be capable of keeping foods at a temperature of 41 degrees fahrenheit or colder.
Based on review of facility policies and procedures and observations, it was determined that the nursing home failed to maintain the resident’s equipment in a sanitary manner. Findings included the following: During an initial tour of the third floor on June 10, 2013 at 9:15 a.m., observations of five feeding tube feeding pumps and poles in rooms: revealed that all five had tube feeding spillage at the pumps and tube feeding poles.