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Based on observation, interview, and document review, the hospital's staff failed to ensure the Food Service department of the hospital was well organized and could maintain the kitchen in a safe and sanitary fashion. The hospital's staff failed to maintain a safe and sanitary environment and ensure food was properly labeled. This failure has the potential to affect all patients receiving care in the hospital.

Findings Include:

1. Observations of the kitchen on 11/26/18 from 9:15 AM to 10:15 AM showed the following concerns:

a) An observation of the walk-in freezer in the kitchen showed an open bag of frozen vegetables that had not been labeled to indicate when the food had been opened or the expiration date. In addition, a large ham, wrapped in plastic wrap, was sitting inside an opened box of frozen chicken.

b) An observation of the dishwasher room showed a three-compartment sink was used for thawing meat by running water over the meat sitting in a metal pan in one of the compartments of the sink. In addition, another compartment of the sink was used for soaking dirty service pans prior to washing the pans in the dishwasher.

c) An observation of the ice machine in the kitchen showed the filters on the front of the machine were covered in dust.

2. Observation of the kitchen area on 11/28/18 at 11:00 AM showed three open bags of uncooked rice in the dry food storage area that were not labeled with the date the bags were opened or the expiration date. In addition, the floor of the dry food storage area was dirty with food debris.

During an interview on 11/26/18 at 10:20 AM, Staff J/Dietary Manager (DM) was not aware of the concerns identified during the tour of the kitchen area. Staff J stated that there had been some turnover in dietary supervisory staff that had created a breakdown in the system by which dietary staff were to ensure foods were labeled and cleaning schedules were followed. In addition, Staff J acknowledged the three-compartment sink should not be used for thawing meat under running water.

During an interview on 11/27/18 at 1:15 PM, Staff R/Human Resource Manager stated that the DM and food service staff were employees of a contracted food service company and responsible for the oversight of the services provided by the food service company. Staff R further stated that the food service company was responsible for ensuring the kitchen area of the hospital was kept clean and maintained a sanitary environment.

Document review of the hospital's agreement titled, "Food and Nutrition Services Management Agreement," dated 06/01/16, showed the food service company was responsible for ensuring floors, walls, equipment, refrigerators, and freezers were cleaned. The agreement further indicated the hospital was responsible for oversight of the agreement. The hospital's staff were not ensuring the food service company followed thorough with the agreement.

Based on observation, interview, and policy review, it was determined the hospital's staff failed to ensure garbage was properly disposed. This failure has the potential to affect all patients and staff at the facility due to the potential for bacteria build up, odors, and rodent infestations.

Findings Include:

Observation on 11/28/18 at 11:15 AM, outside the service entrance of the hospital showed two garbage dumpsters used for collecting garbage at the facility with broken lids, leaving the dumpsters uncovered. In addition, garbage debris was observed on the pavement in front of the dumpster.

During an interview on 11/28/18 at 11:15 AM, Staff S/Plant Manager (PM) stated that the garbage was taken out of the facility by food service and housekeeping staff. The garbage was taken outside the service entrance and placed in the dumpsters. Staff S stated that the dumpsters were rented from the city sanitation department. In addition, Staff S acknowledged the lids were broken, but did not indicate the sanitation department had been contacted to replace the broken lids on the dumpsters.

Review of the hospital's policy titled, "Trash Disposal," dated 06/16/17 showed, the hospital's staff were required to maintain a sanitary and safe environment. However, the policy did not address the use of coverings on dumpsters to prevent infestation. The policy showed, "If the trash receptacle is not in continuous use, it is covered by a lid...employees were responsible for taking trash out at the end of each shift." The hospital's staff were not following their policy.