Health inspection·January 19, 2024

F 0812 Level of Harm - Minimal harm or potential for actual harm Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observation, interview and record review, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety for the walk-in refrigerator in that: Residents Affected - Some -The facility stored unlabeled and unsealed foods in the freezer. This failure had the potential to place residents at risk of serious complications from foodborne illness as a result of their compromised health status. Findings Included: Interview and observations on 01/17/2024 at 8:22 AM with the Dietary Manager. In freezer #1 there were unlabeled bags of what the Dietary Manager identified as diced ham, chicken fried steak, and taquitos. The Dietary Manager said the bags should be labeled. Interview on 01/18/2024 at 9:05 AM with the Dietary Manager. He said he was responsible for ensuring residents are served what they needed and what they were supposed to have. He said he was responsible for the day-to-day things like inventory, ordering, training, and interviewing patients on their preferences He said the food items must be dated with the pick sticker. The pick stick contains ithe information of the date delivered, and the date it was received which he said he physically wrote on the sticker. He said the reason for the failure was the items that were unlabeled were uncooked, they were not labeled and placed in freezer #1. He said the taquitos had not been served since he had been at the facility. He said he discarded the unlabeled foods yesterday (1/17/24). He said he had not been in-serviced on food storage. He said he was responsible for ensuring policy was followed. He said the risk to residents if policy was not followed was a health risk to the residents. He said death was the worst thing to happen if policy was not followed. He said he did not know why the failure occurred, just that those foods had not been served since he had been there. Interview on 01/18/2024 at 11:01 AM with the Administrator. She said she had worked at the facility for five months. She said she oversaw all departments, was abuse coordinator, problem solver and ensured residents were taken care of. She said the policy or procedure for storing food was, everything needed to be dated, and if opened it needed to have an open date and an expiration date. She said the shelf life of items in the fridge was three days. She said she did not know why the items were not dated and that staff did not follow up. She said she last had training on food storage about two months ago. She said the risk to residents if policy were not followed was, they could get sick from food borne illnesses. She said the worst thing that could happen was residents got sick and ended up in the hospital or worse. She said she thought the failure occurred because staff may have been in (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 3 Event ID: 675361 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 675361 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/19/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wharton Nursing and Rehabilitation Center 1220 Sunny Lane Wharton, TX 77488 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)