Health inspection·August 13, 2024

F 0802 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. Based on observations, interviews, and record review , the facility failed to provide sufficient support personnel with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service for 5 (Dietary A, Dietary B, Dietary C, Dietary D, and Dietary E) of 9 dietary staff. The facility did not ensure 5 (Dietary A, Dietary B, Dietary C, Dietary D, and Dietary E) of 9 dietary staff had a current food handler's certificate from the date of hire until August 13, 2024 . This failure could place all residents who consumed food prepared from the kitchen at risk of foodborne illness. Findings included: Review of records dated 08/13/2024 revealed Dietary Staff A, Dietary Staff B, Dietary Staff C, Dietary Staff D, and Dietary Staff E did not have food handlers' certificates while employed at the facility. In an interview with the DM on 08/13/2024 at 03:25 PM she stated the employees were required to go through Relias (a computer-based education system) training and then work with her for on the job training and onboarding for multiple days, but at minimum 3 days. She acknowledged that it was required for all dietary staff to have an accredited food handlers' certificate before working in the kitchen. She said the last person was hired over 6 months ago. She stated that this could put the residents at risk for foodborne illness if not trained properly. In an interview with the Administrator on 08/13/2024 at 3:35 PM she stated that employees were required to spend the first week of employment completing the Relias training required by their corporate office. She said that she relied on corporate for training policies and a training system to ensure accreditation standards were up to date. She said she knew all kitchen staff needed a food handlers' certification, but thought Relias was accredited because of guidance from her corporate office. She refused to acknowledge the question about any potential negative outcomes due to a lapse in training. She stated that in-service training's were reactionary, and all staff departments were provided in-services after events had happened. She stated that there has been in-service training performed for dietary staff but failed to provide records for in-services. In an interview on 08/13/2024 at 3:40pm with the Relias customer service phone line he stated that Relias was not affiliated with any state level accreditation programs but has objectives that could serve to meet competencies. No in-service training for dietary aids was provided by the time of (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 4 Event ID: 675201 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 675201 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/13/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Hillside Medical Lodge 300 S. Highway 36 Bypass Gatesville, TX 76528 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)