Based on observations, interviews, and review of facility policies Storage Areas and Personal Appearance and Conduct revealed that the facility failed to label, and date opened food items in the walk-in refrigerator and failed to ensure dietary staff wore a hair net in the kitchen during food preparation and meal service to prevent food contamination. This deficient practice had the potential to effect 37 of 38 residents receiving an oral diet. Findings include: Review of the undated facility policy titled Storage Areas revealed - Items will be covered, sealed, labeled, and dated appropriately. Review of the undated facility policy titled Personal Appearance and Conduct revealed - Hair restraints, a hairnet and/or beard restraint will be worn while in the food prep, production, and servicing areas. Observation on 6/18/22 at 8:20 a.m. of the walk-in refrigerator revealed a package of sliced deli turkey meat was opened, wrapped with no open date. Continued observation revealed a square metal pan with cut lemon wedges, covered with no label or date. Also, a one-gallon container of Buttermilk Ranch Dressing was opened with no open date. Observation on 6/18/22 at 11:45 a.m. of the Certified Dietary Manager (CDM) in the kitchen preparing puree foods items for lunch meal revealed she was not wearing a hair net. Observation on 6/18/22 at 12:30 p.m. of the CDM revealed she was assisting with serving resident lunch meal and was not wearing hair net. During an interview on 6/18/22 at 8:25 a.m. the CDM confirmed the package of sliced deli turkey meat, lemon wedges, and Buttermilk Ranch Dressing did not have a label or open date. Continued interview with the CDM revealed she expects dietary staff to label and date food items after opening. During an interview on 6/18/22 at 2:30 p.m. the CDM revealed that she did not realize that her hair was not covered with a hair net. The CDM stated that she had put a hair net on when she arrived, and it must have fallen off. Continued interview with the CDM revealed she expects staff and even herself to wear a hair net while in the kitchen.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, medical record review and staff interview, the facility failed to ensure that one resident (R#33) of three residents with a urinary catheter was handled in a sanitary manner to prevent the spread of infection. Findings include: Observation on 9/9/19 at 2:22 p.m. revealed that resident (R) #33 was out of bed in a wheelchair and the catheter tubing was lying on the floor. The urine in the tubing was observed to be cloudy. Record reveiw for R#33 revealed the following diagnoses: malignant neoplasm of the vagina, overactive bladder, urinary retention, and other cystostomy status. A review of the Physician Orders revealed an order for a suprapubic catheter for urinary retention, Suprapubic 22 French with 10 cubic centimeter bulb for urinary retention, oxybutnin chloride 5 milligram (mg) give three times a day for overactive bladder, tamsulosin ER 0.4 mg, give one every 24 hours for urinary retention; cleanse supra pubic site with soap and water on day shift, pat dry and apply dressing; cleanse suprapubic site with soap and water as needed, pat dry and apply dressing. A review of the Quarterly Minimum Data Sets (MDS) dated [DATE] documented that the resident had a catheter in the seven-day look-back period. The Quarterly MDS also documented that the resident had a urinary tract infection in the 30-day look back period. A review of the care plan revealed that R#33 had a urinary catheter related to an indwelling/suprapubic catheter. An observation on 9/11/19 at 7:41 a.m. revealed that the resident was lying in bed and the catheter tubing was lying on the floor. The urine in the tubing was very cloudy. An observation on 9/12/19 at 10:19 a.m. of the resident revealed that the resident was in bed and the catheter tubing was lying on the floor. An observation and interview on 9/12/19 at 11:46 a.m. with the Director of Nursing confirmed that the tubing for the catheter was on the floor and that this was an infection control issue.