Inspection·October 26, 2023

F 0578 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few normally work on that hallway and that was why she did not Resident #137's code status. She said that morning was only her second time working with Resident #137. She said Staff J, CNA did tell her that morning that Resident #137 did not eat any food from her breakfast tray. Staff B also said she had not given Resident #137 any of her morning medications for the day prior to the code situation. Staff B stated Resident #137 was often observed by the staff to lie in her bed with her mouth open and she often yelled out and made a lot of noise. She said because of this, her door was often left closed so she would not disturb the other residents on the hallway. When asked when she last assessed Resident #137 that morning, Staff B stated she had seen her to do her vital signs and that Staff J saw her to assist her with her breakfast meal tray. An interview was conducted with Staff J, CNA on 10/23/23 at 11:22 AM. Staff J stated she knew Resident #137 well as she normally worked on that floor. She said Resident #137 was always yelling out and making lots of noise and that she often sat with her mouth wide open. She said she always helped her with her meal trays and that she was unable to eat by herself. Staff J said Resident #137 often refused to eat her food, but that she was usually able to feed her orange juice or oatmeal. She said that morning at about 9:30 AM, she tried giving Resident #137 some orange juice from her breakfast tray, but the resident did not eat anything from her breakfast tray. The facility Director of Nursing (DON) compiled a timeline of events surrounding the code response. It documented Staff B obtained Resident #137's vital signs around 7:30 AM and that Staff J attempted to assist Resident #137 with her breakfast tray around 9:30 AM. It also documented the surveyor observed Resident #137's cardiac failure around 10:18 AM. An interview was conducted with the facility Director of Nursing (DON) on 10/25/23 at 10:19 AM. She stated she understood the surveyor's concerns regarding the delay in treatment for Resident #137's cardiac arrest. She stated the nurse should have called out for assistance instead of walking to the nurse's station herself. She also said the resident name bands have a colored block on them if the resident is a DNR, so the nurse should not have had to leave the room to check the chart to confirm Resident #137's code status, but rather she could have checked the name band and confirmed there was no colored block. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105083 If continuation sheet Page 2 of 10 Printed: 05/28/2026 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 105083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/26/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Broward Nursing & Rehabilitation Center 1330 S Andrews Ave Fort Lauderdale, FL 33316 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)

F 0693 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record review, the facility failed to follow tube feeding orders for 1 of 2 residents reviewed for tube feedings (Resident #127). The findings included: The facility policy titled Care and Treatment of Feeding Tubes, revised on 09/28/23, revealed the following: feeding tubes will be utilized according to physician's orders, which typically include the kind of feeding and its caloric value, volume, duration, mechanism of administration and frequency of flushes. Resident #127 was readmitted on [DATE] with diagnoses of sepsis, dysphagia, and iron deficiency anemia. Order dated 07/25/23 revealed enteral feeding with Jevity 1.5 (tube feeding formulary) at 55 milliliters (ml) an hour for 23 hours, providing 1898 calories every 24 hours. It further showed that Resident #127 needed tube feeding related to failure to thrive. In an observation conducted on 10/23/23 at 10:55 AM, The tube feeding was noted with Jevity 1.5 at 55 ml an hour, which started at 12:30 AM that morning. Closer observation showed that the tube feeding was at the 1300 ml mark on the 1500 ml capacity bottle. The tube feeding that started at 12:30 AM, running at 55 ml an hour, should have been at the 950 ml mark and not at the 1300 ml mark. In an observation conducted on 10/24/23 at 9:10 AM, the same tube feeding bottle was noted from the day before, which was at the 100 ml mark on the 1500 ml capacity bottle. In an observation conducted on 10/25/23 at 8:50 AM, Resident #127's tube feeding was running at 55 ml an hour. Closer observation showed that the tube feeding started at 7:15 AM this morning. It was still noted at the 1500 ml mark. In an observation conducted on 10/25/23 at 4:30 PM, Resident #127 was in the room with the tube feeding Jevity 1.5 running at 55 ml an hour, which started that morning at 7:15 AM. Closer observation showed that the tube feeding was still at the 1500 ml mark. This showed that no tube feeding was administered to Resident #127 in the last 9 hours. In an observation conducted on 10/26/23 at 6:58 AM, Resident #127 was in her room with the tube feeding running at 55 ml an hour, which showed a start time of 7:25 AM and dated 10/26/23. In an interview conducted on 10/26/23 at 7:05 AM with Staff C, the Registered Nurse stated that she changed the tube feeding that was running all night this morning to a new tube feeding bottle. When asked as to where was the tube feeding level when she removed the old bottle, she said there was around ¼ left to the end of the bottle. Staff C said that she always replaces a new tube feeding bottle when it is close to the end of the bottle and that Resident #127 tolerates her tube feeding well. In an interview conducted on 10/26/23 at 9:02 AM with Staff D, the Registered Dietitian stated that the nursing staff would replace the tube feeding bottle when it is all completed. When asked regarding Resident #127's tube feeding orders, he reported that if it runs at 55 ml an hour for about 24 (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105083 If continuation sheet Page 3 of 10 Printed: 05/28/2026 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 105083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/26/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Broward Nursing & Rehabilitation Center 1330 S Andrews Ave Fort Lauderdale, FL 33316 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)

F 0693 Level of Harm - Minimal harm or potential for actual harm hours, it will provide 1980 calories and 84 grams of protein a day. Regarding the observation by the Surveyor on 10/24/23, Staff D said that the tube feeding bottle should have been around the 950 ml mark on the 1500 ml bottle. The bottle should have been empty around 3:30 AM on 10/24/23. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105083 If continuation sheet Page 4 of 10 Printed: 05/28/2026 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 105083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/26/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Broward Nursing & Rehabilitation Center 1330 S Andrews Ave Fort Lauderdale, FL 33316 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)

F 0760 Ensure that residents are free from significant medication errors. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record reviews, the facility failed to follow physician orders for 1 of 6 residents reviewed for unnecessary medication review (Resident #395). Residents Affected - Few The findings included: Review of the facility policy titled Medication Orders, dated 05/2022 revealed the Elements of the Medication Order must include the quantity or duration (length) of therapy. Resident #395 was admitted to the facility on [DATE]. She was discharged from the facility on 08/05/23. Resident #395 had a medical history significant for Falls, Right Hip Injury, Cardiac Pacemaker, Weakness, and Anemia. A Care Plan was written on 08/07/23 which stated [Resident #395] is on anticoagulant therapy Lovenox with the goal of the resident will be free from discomfort or adverse reactions related to anticoagulant use through the review date of 07/19/23. Review of the paper chart revealed a handwritten order written on 07/07/23 from the physician's nurse practitioner which stated Lovenox 40mg subQ (subcutaneously) Qdaily (one time daily) x (for) 10 days. Review of the electronic chart revealed an order written by Staff I, Registered Nurse Unit Manager on 07/07/23 which stated Enoxaparin Sodium Solution 40 MG/0.4ML Inject 40 milligram subcutaneously one time a day for prevent blood clotting give for 10 days. However, this order did not include a stop date. Review of the physician notes revealed Resident #395 was seen six times by the physician and the nurse practitioner during her stay at the facility. However, no stop date was placed on the Lovenox order. Review of the Medication Administration Record revealed Resident #395 received Lovenox injections daily from 07/07/23 through 08/02/23 (26 days). An interview was conducted with the resident's daughter on 10/24/23 at 3:08 PM. She stated she talked with the DON regarding this concern and that the DON told her she could not believe the nurse or Pharmacist didn't put a stop date on the order. She said she wanted to make sure the residents were being cared for in a safe environment and that this mistake did not happen to another resident. She said she wanted to make sure that the facility has to put safety measures and ongoing education in place to ensure this did not happen again. She said Resident #395 was OK and no harm came to her due to this medication error. An interview was conducted with Staff H on 10/25/23 at 1:40 PM. Staff H stated he remembered speaking to the resident's daughter regarding the medication concern but that he did not write the order for the medication. He reviewed Resident #395's chart and saw the order was written by Staff I, Registered Nurse Unit Manager. An interview was conducted with the facility's Director of Nursing (DON) on 10/25/23 at 3:43 PM. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105083 If continuation sheet Page 5 of 10 Printed: 05/28/2026 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 105083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/26/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Broward Nursing & Rehabilitation Center 1330 S Andrews Ave Fort Lauderdale, FL 33316 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)

F 0760 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few She stated she did not remember discussing this concern with Resident #395 or her family. She reviewed Resident #395's paper chart and electronic chart and discovered the error of the missing stop date on the order. The DON agreed that the medication error happened. She said I can't believe pharmacy didn't catch it. She explained that it was also the nurse's responsibility to review the orders prior to administering the medications and someone should have caught the 10 day stop time. She confirmed the physician and nurse practitioner saw the resident 6 times after the order was written and did not catch that there was no stop date on the medication. She confirmed that the nurses are supposed to review the order for the medications when they are administering them. An interview was conducted with Staff I, Registered Nurse Unit Manager on 10/26/23 at 10:43 AM. She stated she did talk to the facility's DON about this concern. She said she remembered she received the order from the nurse practitioner and put it into the computer and that she did put for 10-days but that she did not scroll down to put in the stop date on the order. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105083 If continuation sheet Page 6 of 10 Printed: 05/28/2026 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 105083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/26/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Broward Nursing & Rehabilitation Center 1330 S Andrews Ave Fort Lauderdale, FL 33316 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)

F 0761 Level of Harm - Potential for minimal harm Residents Affected - Some Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations and interviews, the facility failed to dispose of expired medical supplies found in 2 of 3 medication supply rooms. The findings included: 1) A medication room observation was conducted on [DATE] at 10:50 AM with Staff F, Registered Nurse for the 1-South medication room. Noted during this tour were the following expired supplies: 2 BinaxNOW COVID-19 tests with the expiration date of [DATE]; 2 Specimen Collection Swabs with the expiration date of [DATE], 2 Specimen Collection Swabs with the expiration date of [DATE]; 3 BBL Culture Swab Plus with the expiration date of [DATE]; 9 BBL Culture Swab Plus with the expiration date of [DATE]. 2) A medication room observation was conducted on [DATE] at 11:17 AM with Staff G, Licensed Practical Nurse for the 2-East medication room. Noted during this tour were the following expired supplies: 1 Adult [NAME] Valve with the expiration date of [DATE]; 1 Non-Conductive Connection Tubing 20 Length with the expiration date of [DATE]; 2 Multi-Function Sterile Red Caps with the expiration date of 03/2023. These expired supplies were discussed with the facility's Director of Nursing on [DATE] at 1:15 PM. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105083 If continuation sheet Page 7 of 10 Printed: 05/28/2026 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 105083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/26/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Broward Nursing & Rehabilitation Center 1330 S Andrews Ave Fort Lauderdale, FL 33316 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)

F 0810 Provide special eating equipment and utensils for residents who need them and appropriate assistance. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record review, the facility failed to provide adaptive devices to assist with eating for 1 of 5 residents reviewed for nutrition (Resident #38). Residents Affected - Few The findings included: A review of the facility's policy titled Adaptive Feeding Equipment dated 02/3/2023 showed the following: the dietary department should be notified of residents needing adaptive equipment. The adaptive equipment is stored and maintained in the dietary department, and appropriate utensils should be placed on the resident's food tray at each meal. Resident #38 was readmitted on [DATE] with diagnoses of Glaucoma, Diabetes and Renal Disease. Order noted on 09/27/23 for adaptive equipment scoop plate with meals to enhance feeding due to poor eyesight. Occupational Therapy screening dated 09/28/23 showed that Resident #38 will benefit from a scoop plate to prevent food spillage due to impaired vision. In an observation conducted on 10/24/23 at 12:34 PM, Resident #38 was in the 2nd-floor dining room eating his lunch. The meal ticket showed a scoop plate under preferences. Closer observation did not show that a scoop plate was provided with his lunch meal. Some food items were observed spilling around the lunch plate. In an observation conducted on 10/24/23 at 5:09 PM, Resident #38 was noted in the 2nd-floor dining room. Closer observation showed that Resident #38 did not receive a scoop plate with his dinner meal. Some food items were observed spilling around his dinner plate. A review of the medical records showed that in the Minimum Data Set (MDS) dated [DATE], Resident #38 has impaired vision. An eye doctor saw Resident #38 on 09/26/23 and reported that Resident #38 has severe diabetic retinopathy (an eye disease that can cause vision loss and blindness). In an interview conducted on 10/26/23 at 8:50 AM with Staff D, a Registered Dietitian, he said that the Occupational Therapist brings them a list of residents who need adaptive devices and what type of adaptive devices are needed. He also runs a list of residents on adaptive devices once a month to see what kind of adaptive devices are required and if the kitchen has enough to provide to all the residents who have orders for adaptive devices. They also have one kitchen staff that oversees placing all the adaptive devices orders in the tracker for the specific residents. Staff D reported that the tray line supervisor ensures the correct adaptive devices are placed on the needed meal trays. It is later checked on the specific units by the nurse supervisors. An interview conducted on 10/26/23 at 11:08 AM with the Assistant Director of Nursing reported that the nurse on shift is in charge of checking the resident's trays in the dining room to ensure that they receive the adaptive devices as ordered. In an interview conducted on 10/26/23 at 2:00 PM with the Director of Nursing, she was informed of the findings. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105083 If continuation sheet Page 8 of 10 Printed: 05/28/2026 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 105083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/26/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Broward Nursing & Rehabilitation Center 1330 S Andrews Ave Fort Lauderdale, FL 33316 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)

F 0813 Have a policy regarding use and storage of foods brought to residents by family and other visitors. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record reviews, the facility failed to follow its own policy regarding food brought from home for 1 of 5 sampled residents reviewed for nutrition (Resident #87). Residents Affected - Few The findings included: A review of the policy titled Food Brought by Family/Visitors/Residents undated showed that staff must be aware of and approve food brought to the residents by family and visitors. The Dietitian or a Nurse Supervisor should ensure that the food is not in conflict with the resident's prescribed diet plan. The Dietitian will counsel residents or families about requests conflicting with resident dietary restrictions and whenever diets cannot be liberalized. Record review revealed that Resident #87 was admitted on [DATE] with diagnoses of unspecific dementia, adult failure to thrive, and dysphagia. A review of active orders showed an order for enteral feeding with Glucerna 1.5 (tube feeding formulary) running at 55 milliliters an hour for 20 hours dated 07/06/23. Pleasure food diet with soft bite-sized chopped meat texture for lunch only dated 07/24/23. A progress note dated 07/05/23 revealed that an order was placed for Resident #87 to have pleasure foods, but due to having a history of dysphagia, a new order was received to have a speech evaluation prior to the pleasure foods being started. A progress note dated 07/14/23 revealed that a Modified Barium Swallow (swallowing test) was done, and it was recommended that Resident #87 be placed on soft and bite size diet consistency and that Resident #87's daughter was educated on the Modified Barium Swallow results. The care plan revised on 10/18/23 showed that Resident #87 is at risk for altered nutrition and hydration status and that pleasure meals with soft and bite-sized textures are to be given at lunch only. In an observation conducted on 10/24/23 at 3:30 PM, Resident #87 was noted in her room with her family members. She was observed eating on her own the food that was brought from home. Closer observation showed a cooked, soft potato in chicken broth, a large piece of corn on the cob, and another bowl with a partially eaten chicken thigh with bones. Continued observation showed that Resident #87 ate the potato in the chicken broth and a few bites of the chicken. In an interview conducted on 10/24/23 at 3:30 PM with Resident #87's daughter, she stated that she comes to see her mom about 3-4 days a week and always brings her food that she made at home. She said that she spoke to her mom's doctor a few months ago and asked if she could get food from home and was told that it was okay as long as Resident #87 could eat the food. According to the daughter, she was never told by the facility staff or the dietary department regarding the food consistency that is allowed or the diet order that is given to her mom at the facility. She did say that, at times, her mom coughs when she eats the food that she brings from home. When asked by Surveyor if the food that was brought from home was checked or approved by staff for safe consumption, she said no. The daughter said that her mom likes the food from home and that she does not like the food that is given to her in the facility. She also did not know that Resident #87 was only getting one meal a day for lunch. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105083 If continuation sheet Page 9 of 10 Printed: 05/28/2026 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 105083 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/26/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Broward Nursing & Rehabilitation Center 1330 S Andrews Ave Fort Lauderdale, FL 33316 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)

F 0813 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few In an interview conducted on 10/24/23 at 3:50 PM, Staff A, Licensed Practical Nurse, stated that Resident #87's family has been coming here for some time and that the daughter brings Resident #87 homemade foods every time she sees her mom. At first, he used to look at the food consistency brought from home and asked the daughter if the dietary department okayed the food, and she said yes. A Dietary progress note dated 10/23/23 revealed to monitor Resident #87's tube feeding orders to monitor intake and acceptance of meals and adjust orders as needed. The Minimum Data Set (MDS) dated [DATE] showed that Resident #87 had a Brief Interview of Mental Status (BIMS) score of 06, which indicated severe cognitive impairment. In an interview conducted on 10/25/23 at 2:56 PM, the facility's Speech Language Pathologist stated that she did not speak or educate Resident #87's daughter regarding bringing food from home. A review of the Soft and Bite-Sized audit tool provided by the facility's Speech Language Pathologist revealed that the food consistency needs to mimic a bite of food that must be equal to or less than 15 millimeters. In a phone interview conducted on 10/26/23 at 10:13 AM, Staff E, Registered Dietitian, stated that she met Resident #87's daughter yesterday and that it was the first time. Resident #87's daughter told her that she wanted to bring soups from home that her mom likes. Staff E reported that she explained to Resident #87's daughter that it was important to have breaks between the tube feeding and the meals brought from home. The Surveyor asked Staff E if she ever saw the food consistencies that the daughter brings from home, and she said no. The Surveyor informed her of the foods observed on 10/24/23. In an interview conducted on 10/26/23 at 12:00 PM, with the Director of Nursing, she was informed of the findings. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 105083 If continuation sheet Page 10 of 10