**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, observations, and interviews the facility failed to dispose of expired blood collection tubes in one medication room (400-500 hall medication room) of one medication room observed for medication storage. The findings include: Review of the facility's policy titled, Medication Storage dated 1/2025, revealed .biologicals are stored properly, following manufacturers or provider .recommendation .storage conditions .monitored on a regular basis as a random quality assurance .check .problems are identified, recommendations are made for corrective action to be taken . During an observation of the 400-500 hall medication room on [DATE] at 1:04 PM, revealed 9- 3 milliliter (ml) blue top blood collection tubes with an expiration date of [DATE] and 28- 4 mL green top blood collection tubes with an expiration date of [DATE] were stored in medication room and was available for resident use. During an observation and interview on [DATE] at 1:09 PM, the Corporate Care Consultant Nurse observed the 9- 3 mL blue top blood collection tubes, confirmed the expiration date was [DATE]. Continued observation and interview with the Corporate Care Consultant Nurse stated the expiration date on the 28- 4 mL green top blood collection tubes was [DATE]. The Corporate Care Consultant Nurse further stated he would reach out to a representative with their contracted laboratory to discuss the date on the blood collection tubes. During an interview on [DATE] at 4:20 PM, the Corporate Care Consultant Nurse confirmed the 9- 3 mL blue top blood collection tubes and the 28- 4 mL green top blood collection tubes were expired and were available for resident use.

Based on facility policy review, observation, and interview, the facility failed to ensure staff wore appropriate beard coverings during food preparation and failed to ensure staff followed appropriate hand hygiene practices during meal preparation in 1 of 1 kitchen observed; potentially affecting 42 of 43 residents. The findings include: Review of facility policy HANDWASHING AND GLOVE USE, last revised 2/1/14, revealed .Hands must be washed .when working with different food substances .and following contact with unsanitary surface .opening doors .Gloves must be changed as often as hands need to be washed .Gloves may be used for one task only .It is important to remember that gloves can often give a false sense of security and can carry germs the same as our hands . Review of facility policy Personal Hygiene, last revised 7/5/18 revealed .Beards or any body hair that may be exposed .must be covered . Observation of the kitchen during meal preparation on 7/29/19 from 11:55-12:25 PM, revealed the Chef and Kitchen Staff #1 with beards. Further observation revealed the Chef and Kitchen Staff #1 did not wear a beard covering during food preparation. Continued observation revealed a cooking utensil fell into a bin containing pork chops with liquid. Further observation revealed the Chef removed the wet utensil from the pork chop bin with a gloved hand, then proceeded to retrieve a piece of bread from a plastic bag, placed the bread on a plate, opened the door to the hot box, retrieved broccoli from the hot box, and placed it in the steamer wearing the same glove. Interview with the Certified Dietary Manager on 7/31/19 at 1:30 PM, in the conference room, confirmed the facility failed to follow appropriate hand hygiene practice during food service and failed to ensure facial hair was covered during meal preparation. Further interview confirmed the facility failed to follow facility policy.