Health inspection·April 24, 2024

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observation, staff interview and record review, the facility failed to ensure safe and sanitary storage of food items in the refrigerator and freezer and failed to ensure kitchen equipment was maintained in a safe and sanitary manner. This had the potential to affect all the residents except for one resident (#62). The facility identified Resident #62 did not receive food from the kitchen. The facility census was 62. Findings include 1. Observations and interview on 04/24/24 at 9:25 A.M. with Kitchen Manager #200 confirmed several items in the refrigerator and freezer were not properly sealed and dated. The items in the refrigerator included: berry dessert undated and uncovered; over six pitchers of lemonade and fruit punch undated; lettuce bag had been opened and was undated; roast beef lunch meat with prep date on 03/19/24 with no use by date; pancake batter with a use by date of 04/22/24; yellow pudding with prep date of 03/29/24 with no use by date; whipped topping was open to air with no open date; block of white cheese slices undated and open to air; and a second block of white cheese slices undated. In the freezer, the items included: several large pork loins undated; several large packs of hamburger meat undated, egg patties left open to air and no open date; bag of meatballs undated; and two bags of sausage patties undated; bag of sausage links undated. Kitchen manager #200 confirmed the food items mentioned were not dated and/or open to air. He revealed he was not aware meat needed to be dated upon delivery. Interview on 04/24/24 at 9:50 A.M. with Corporate Dietician (CD) #250 confirmed the facility had issues with kitchen sanitation and confirmed food should be dated upon delivery and when opened or removed from original packaging (ie. box with the date on it). She revealed lunch meat should be kept no more than five to seven days. CD #250 confirmed all food items being stored in the refrigerator or freezer should be sealed and covered. Review of the facility policy titled Food Storage Guidelines, dated 01/01/12, revealed food shall be stored in a manner to prevent contamination. Food stock shall be dated with each order and should be covered, labeled and dated Review of the facility policy titled Labeling and Dating Food, dated 01/01/12, revealed all food items shall be properly labeled and dated to ensure food to be used can be consumed, or discarded properly. The policy revealed the items delivered would be properly stored and clearly marked with name and delivery date on the original container. The date shall be updated after opening, and if cooked and cooled for no longer than seven days. Expired food shall be discarded on or before the last date or day food should be consumed by including items such as animal products, vegetables and plant (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 366142 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366142 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/24/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mill Run Care Center 3399 Mill Run Drive Hilliard, OH 43026 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)