NASHVILLE, TN - Federal inspectors documented significant food safety and infection control violations at NHC Place At the Trace during a February inspection, revealing contaminated kitchen equipment, malfunctioning dishwasher systems, and improper hygiene practices that potentially exposed 82 residents to health risks.
Widespread Kitchen Contamination Threatens Food Safety
The inspection revealed extensive sanitation failures throughout the facility's kitchen that served meals to all 82 residents daily. Inspectors documented soiled surfaces, contaminated equipment, and improper food storage that violated fundamental food safety protocols.
Kitchen staff failed to maintain basic cleanliness standards across multiple areas. Inspectors found cooking pots hanging above sinks with black buildup on their bottoms, while a perforated pan contained dried food particles despite being stored as clean equipment. Two dessert bowls stored in a container had cantaloupe stuck between them, indicating inadequate washing procedures.
The contamination extended to critical food preparation equipment. A metal mixing kettle and stand mixer showed buildup from spillage and dried food particles. Plastic storage containers were soiled with breadcrumbs, rice, and fish batter splatters on their exterior surfaces. A metal drying rack displayed dried food residue and tan spillage on its sides and bottom.
The char-grill presented particularly concerning conditions with thick carbon buildup. Food preparation surfaces included a metal prep table with dried spillage and food particles on its bottom shelf. Most significantly, floors throughout the kitchen were soiled, with thick black buildup accumulating under the deep fryer.
These conditions create multiple pathways for foodborne illness transmission. When cooking surfaces and utensils retain food particles and organic matter, they become breeding grounds for harmful bacteria including Salmonella, E. coli, and Listeria. Cross-contamination occurs when improperly cleaned equipment contacts fresh food, potentially transferring pathogens throughout the food supply.
Dishwasher System Failures Compromise Sanitation
The facility's dishwasher system experienced persistent temperature failures that prevented proper sanitization of dishes and utensils used by residents. Federal regulations require high-temperature dishwashers to maintain wash temperatures of at least 165°F and final rinse temperatures of 180°F to effectively kill harmful microorganisms.
Temperature logs revealed systematic violations over multiple days. On one occasion, the final rinse temperature dropped to just 151°F during operation. Records showed temperatures below the required 180°F threshold on numerous dates, with some readings as low as 169°F for extended periods.
During the inspection, a test tray placed in the dishwasher recorded a final rinse temperature of only 160°F, well below safety standards. The facility's dishwasher technician confirmed the system "rinse temp not meeting 180 degrees" and documented readings as low as 144°F.
The temperature failures represent a critical breakdown in infection control. Proper dishwasher sanitization requires sustained high temperatures to denature proteins in bacteria and viruses, effectively destroying their cellular structure. When temperatures fall below 180°F, pathogenic microorganisms can survive the washing process and contaminate clean dishes, creating direct transmission pathways to residents.
Service records revealed ongoing mechanical problems including a leaking vacuum breaker, damaged temperature probe, and missing electrical power to the booster system. To address the immediate safety concern, technicians installed a chemical sanitization system as a temporary measure. However, facility staff lacked the proper test strips needed to verify chemical sanitizer levels, leaving them unable to confirm effective sanitization.
Food Storage and Staff Hygiene Violations
Inspectors identified multiple food safety violations that increased contamination risks. Open loaves of bread stored above the serving line lacked proper dating labels, making it impossible to determine their safety for consumption. The facility stored expired grape juice containers in both reach-in and walk-in refrigerators, with some items days past their expiration dates.
Staff hygiene practices violated basic food safety protocols during meal service. One cook was observed leaving the serving line multiple times, touching various surfaces including warming oven handles, then returning to food service without changing gloves or performing hand hygiene. The same staff member handled sweet potatoes with contaminated gloves after touching other kitchen surfaces.
These practices create direct contamination pathways between environmental surfaces and food served to residents. When staff fail to change gloves or wash hands between tasks, they transfer microorganisms from equipment and surfaces directly to food items. This cross-contamination significantly increases the risk of foodborne illness among vulnerable nursing home residents.
Infection Control Failures in Medical Care
Beyond kitchen operations, inspectors documented infection control violations during medical care delivery. A registered nurse failed to follow proper hand hygiene protocols while monitoring blood glucose levels for a diabetic resident. The nurse washed her hands appropriately but then turned off the water faucet with her bare hand, recontaminating her hands with bacteria from the faucet handle.
During insulin administration to the same resident, the nurse used an alcohol pad to clean the injection site, placed the contaminated pad directly on an overbed table without a protective barrier, then picked up the same pad and reused it to clean the injection site again. This practice introduces environmental contaminants directly into the injection site, creating infection risks for immunocompromised residents.
Proper injection site preparation requires using a fresh alcohol pad for each cleaning step and never reusing contaminated materials. When alcohol pads contact unsterile surfaces, they pick up environmental bacteria that can cause serious skin and soft tissue infections when introduced through injection sites.
Medical Significance and Health Risks
These violations pose particularly serious risks for nursing home residents who often have compromised immune systems due to advanced age, chronic medical conditions, and medications. Foodborne pathogens that might cause mild illness in healthy adults can trigger severe complications including sepsis, pneumonia, and death in vulnerable elderly populations.
The combination of kitchen sanitation failures and dishwasher temperature problems created multiple contamination pathways throughout the food service system. When dishes aren't properly sanitized and food preparation surfaces remain contaminated, harmful bacteria multiply and spread throughout the facility's food supply.
Infection control violations during medical procedures compound these risks. Diabetic residents like the one observed during the inspection face elevated infection risks due to compromised wound healing and immune function associated with diabetes. Contaminated injection sites can lead to cellulitis, abscess formation, and bloodstream infections that require hospitalization.
Regulatory Standards and Industry Expectations
Federal nursing home regulations mandate strict adherence to food safety and infection control protocols specifically because of the vulnerable population these facilities serve. The documented violations represent systematic failures to meet minimum safety standards established to protect resident health.
Professional food service standards require daily cleaning and sanitization of all equipment, proper food storage with clear labeling and dating, and maintenance of dishwasher systems within specified temperature ranges. When these systems fail, facilities must implement immediate corrective measures including switching to disposable serving items and conducting enhanced monitoring.
Additional Issues Identified
The inspection documented several other concerning practices including improper storage of opened food items without dating labels, failure to discard expired products by their use-by dates, and inadequate communication between kitchen staff and management regarding equipment failures. Staff members responsible for dishwasher operations were unable to explain proper procedures when temperatures dropped below acceptable levels, indicating insufficient training on food safety protocols.
Temperature monitoring logs showed a pattern of substandard performance over multiple weeks, suggesting that facility management was aware of ongoing problems but failed to implement effective corrective measures until the federal inspection occurred.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Nhc Place At the Trace from 2025-02-12 including all violations, facility responses, and corrective action plans.
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