Health inspection·May 17, 2024

F 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 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 1 of 1 kitchen reviewed for kitchen sanitation. 1. The facility failed to properly store, date, and label food items in the walk-in freezer. These failures could place residents who received meals and/or snacks from the kitchen at risk for food borne illness. The findings included: Observation on 05/15/2024 at 09:45 AM in the walk-in freezer revealed, two open cases of food: one case of frozen cookies and one case of hamburger patties. Both open cases had interior plastic bags that were open, exposing the food to the ambient air in the freezer and subjecting the food to potential contaminants, freezer burn and a decrease in quality. In the walk-freezer was also a coil of sausage with no covering or packaging with the food in direct contact with the metal shelf. The cookies, the beef patties, and the sausage were not labeled or dated. During an interview on 05/16/2024 at 11:23 AM, the Dietary Manager stated the policy is for all food to be sealed, labeled, and dated with the received or open date and expiration or best use by date. The three cases of food were open, and their interior bags were open and should not have been. The Dietary Manager further stated she was responsible for ensuring the food was properly sealed to maintain freshness . She reported that the food should be dated and labeled at the time it is taken off of the supply truck. Record review of the facility policy, HSG Policy 017, revised 02/2023, indicates that, All food items will be appropriately labeled and dated either through manufacturer packaging or staff notation and that, All foods will be stored wrapped or in covered containers, labeled and dated, and arranged in a manner to prevent cross contamination. Record review of the Food Code, U.S. Public Health Service, U.S. FDA, 2022, U.S. Department of H&HS, revealed: 3-302 Preventing food and ingredient contamination. 3-302.11 Packaged and Unpackaged Food Separation, Packaging, and Segregation. (A) Food shall be protected from cross contamination by: (4) Except as specified under Subparagraph 3-501.15(B)(2) and in (B) of this section, storing the food in packages, covered containers, or wrappings. (6) Protecting food containers that are received packaged together in a case or overwrap from cuts when the case or overwrap is opened. 3-305.11 Food Storage. (A) Except as specified in (B) and (C) of this section, FOOD shall be protected from (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: 676492 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 676492 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Methodist Transitional Care Center-Desoto LLC 109 Methodist Way Desoto, TX 75115 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)