HUDSON — A nursing home that state inspectors said was putting patients in "immediate jeopardy" has submitted an acceptable correction plan, an important step toward regaining its government funding. However, inspectors still need to pay a follow up visit to make sure the plan is being followed.
Bayonet Point Health and Rehabilitation Center was cited with four deficiencies related to its dishwasher, which was not reaching proper temperatures required to protect patients from food-borne illness.
Last month federal officials put the 180-bed center on notice that it could no longer accept new Medicare and Medicaid patients until the problems were fixed. Existing patients enrolled in such programs would have 30 days to move.
Nursing home administrator David Cross downplayed the issues last month, saying it was "much ado about a dishwasher" that wasn't quite up to par the day of the inspection.
Cross said the dishwasher, bought in 2000, was being replaced, and noted staff has a dishwasher malfunction protocol that includes washing dishes in three compartment sinks, using chemical sanitizer and disposable dishes.
But a report from the state Agency for Health Care Administration tells a different story.
The report, which the St. Petersburg Times requested under the Florida open records law, indicates that the dishwasher had been failing to reach proper temperatures for at least a month before the inspection.
Health codes say the temperatures much reach at least 160 degrees Fahrenheit during the wash cycle and 180 degrees during the rinse cycle.
Records show the wash temperature at Bayonet Point was 141 degrees, and the rinse temperature was 160 degrees during the Jan. 4 visit from the state.
The dietary manager told the inspector that the dishes should be run through three times to reach the proper temperature.
However, inspectors watched three uses and noted that each time the temperatures registered the same.
A review of the temperature log kept by the center from Dec. 1 to Jan. 4 showed 11 times where the temperatures were below the requirements.
The dietary manager told inspectors that she was aware that the temperatures were not satisfactory and had no documentation that the service company was called to fix the problems, the report said.
It also said the manager could produce no evidence that alternative dishwashing methods or single use eating ware had been used. She said she had informed the administrator about the matter though she had no documentation to back up her claim.
The report also quoted the administrator as telling inspectors that "as long as the rinse cycle was at 180 degrees F it doesn't matter what the wash cycle is."
"Throughout the month of December and up until the day of the (inspection) the facility continued to operate the dish machine knowing its temperatures were not in compliance with the manufacturer's recommendations, which led to immediate jeopardy," the report said.
The morning of the inspection, the manager said the center would use alternative dishwashing methods or single service dinnerware.
But at lunch, 20 residents were served dessert and/or fruit out of multi-use dishes.
Later, inspectors noted that the dishwasher did not have signs telling workers not to use it or any dishes that had been washed in it.
Other examples of kitchen problems included staffers not properly wearing hair or beard nets and failing to change gloves or wash their hands long enough.
One aide who was putting desserts on trays "placed rubber gloves under her armpit as she dried her hands and then placed the gloves on her hands and continued to place desserts on trays," the report said.
It also cited other deficiencies, though they were not deemed life threatening. Those included cracked shower tiles, ripped wallpaper, delays in responding to patients' call lights, gouged walls, and toilets with "biogrowth."
Cross, the nursing home administrator, declined this week to comment on the report, citing the facility's possible appeal of the state's findings. The center's attorney, Ted Mack, said the report was based on "assumptions."
"There's no proof the plates were not washed properly," he said, adding that no one was sickened by food borne illness. He also pointed out that household dishwashers don't heat water to the temperatures required by commercial dishwashers.
"Is your home dishwasher making you sick?" he said. Mack said the center submits corrections before the appeal hearing because the law requires it, not because the center is admitting guilt.
The center submitted a list of steps it said were taken to correct the problems, including:
• Telling staff not to use the dishwasher until it could be repaired.
• Using alternative dish-cleaning methods and disposable serving ware
• Reviewing records to determine whether food borne illnesses had been experienced or reported. None were found.
• Training kitchen workers on proper procedures and how to report equipment problems as well as proper food handling, glove and hair net use.
• Instructing managers to use heat-sensitive test strips to perform spot checks whenever dishwasher temperatures are in question. They also will conduct random audits of the temperatures and reporting process.
Lisa Buie can be reached at [email protected] or (813) 909-4604.