The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

CLEVELAND CLINIC INDIAN RIVER HOSPITAL 1000 36TH ST VERO BEACH, FL 32960 April 15, 2015
VIOLATION: PATIENT RIGHTS: CARE IN SAFE SETTING Tag No: A0144
Based on observation, staff interview and facility record review, the facility failed to ensure:
Equipment fans, intake vents, and surfaces were clean, food preparation equipment was cleaned and sanitized between use, clean dishes were protected from contamination during storage, and hand hygiene was insufficiently performed. All of which increase the risk of cross contamination and potential for food borne illness and have the potential to affect all patients and staff who ingest food from the kitchen.

The findings include:

A review of the Indian River Medical Center Policy and Procedure manual revealed:
Kitchen Policy number K-1 reviewed 1/2015.
- can openers must be washed and sanitized daily.
- All food grinders, choppers, mixers, blenders, etc will be cleaned, sanitized, air dried and reassembled after each use. If equipment cannot be cleaned after each use, it should not be left for more than 1 hour before using again.
-. All food carts will be washed and sanitized after each meal service.
-. All work surfaces, utensils, and equipment will be cleaned and sanitized after each use.
-Walls, baseboards, ceilings, and vents will be cleaned and sanitized every three months.
Policy number K-4
-All exposed surfaces, such as counter tops and steamtables, will be cleaned daily.
-Equipment and utensils such as slicer's, mixers, chopping boards, which come into contact with food will be cleaned soon after use to prevent bacterial growth.
Policy Number K-8
-Temperatures are recorded at each meal for foods at time of service. Suggested temperature standards - start of service for Soups-160-180 degrees
Policy Number K-24
-Warming ovens cleaned daily and thorough cleaning weekly.

During the observational tour starting at 10 AM on 04/14/2015 and continuing to 12 Noon, accompanied by the Food Service Director, the following concerns were identified:
1) In the AL cooler, where produce is stored, the fan had blackish brown residue visible on the cover.
2) In the salad preparation area, the can opener has visible rust on the gear.
3) The grooved metal tomato slicer was placed in a food preparation sink after use. Salad worker stated she rinses it off in the food preparation sink instead of sending it the pot sink for sanitizing.
4) In the cook ' s area, a food processor used to puree food, was visibly wet and had not been properly sanitized and air dried.
5) In the trayline area, the door to a reach in refrigerator had sticky tape residue to which grime had adhered
6) At 11 AM, the blender in the trayline area used for making milkshakes was wet and had not been sanitized and air dried after use. FS Supervisor stated it would be cleaned and sanitized at the end of the trayline approximately 1 PM.
7) The ice cream freezer in the trayline area has visible rust at the upper sides and is heavily laden with frost.
8) The four orders of blenderized soup were placed in a insulated bowl and not on direct heat for holding. The temperature of one bowl was 137 degrees. No monitoring of time and temperature during holding.
9) A food transport cart in line to receive food trays to deliver upstairs, was visibly dirty with a circular dust print in the shape of a shoe.
10) In the cook ' s serving area, the stainless steel shelf under the steam table, was visibly dirty with brown round spots that could be removed with a finger.
11) The small under counter warmer in the cook ' s serving area, had black electrical tape applied to gasket and over the top front. The interior had a coating of carbonized food residue around the bottom.
12) A trash can lid in the cook ' s area was heavily soiled and had not been cleaned recently.
13) The large ice machine filter at the top of the machine had an accumulation of dusty hanging on the filter which is above the ice dispensing area.
14) The food service worker (FSW) who was wiping the food transport carts was observed dipping her cloth into a plastic glass which contained a small amount of fluid and wiping the carts. The FSD corrected her work method and said the carts should be sprayed down with sanitizer.
15) In the pot and pan cleaning area, the FSW placed his large heavy duty pot washing gloves on top of the clean pots in the Pot Wash machine. The FSD had him rewash the pots.
16) The tray drying rack has visible rust on the wheels and around the metal holders for the trays.
17) The dish dolly stored on the clean side of the dish room, had visible debris in the bottom and around the edges. The FS supervisor stated it is not covered between use. The eating surfaces of the plates and bowls is facing up so dust and splashes could hit the surface.
18) Observations of staff washing their hands, revealed 5-6 second hand wash for one FSW and 10 second hand wash for another. The two staff members verbalized hand washing should be 20 seconds. Another staff member was observed removing gloves after a task and did not wash his hand. When ask when about hand washing, he did not clearly state hand washing should occur after glove removal.
At 12:02 PM, the ice dispenser in the pantry on the 4 north unit was observed and found to have discoloration above the area where the ice is dispensed. At 2:25 PM, accompanied by the IP, the ice dispenser in the pantry on the 3 south unit was found to have discoloration and beverage splashes above the area where the ice is dispensed.