Health inspection·June 29, 2023

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Based on interview and record review, the facility failed to honor the resident's choice of food for one (Resident #109) out of three residents investigated for food. This deficient practice has the potential to limit the residents' right to make personal dietary choices. The facility had a census of 136 residents at the time of this survey. Findings included: During an interview on 06/26/23 at 10:36 AM, Resident #109 stated, I don't like the food. I used to get boiled eggs, but now they changed it to scrambled eggs. I don't like scrambled eggs; I preferred boiled egg. I never eat scrambled or fried eggs. They can see that I never eat their eggs. During an interview on 06/28/23 at 09:18 AM with Staff B, a CNA (Certified Nursing Assistant), regarding resident's food choices, Staff B stated, as CNAs, they don't really know about the residents' diet. They only go and set up the food for the residents; however, the residents always have options when they give them the food. They can call the kitchen or let them know if they don't like the food, so they can bring something else. Staff B further stated, she knew Resident #109 sometimes requests for other food. She stated, she had seen they sent her boiled eggs and sometimes scrambled eggs, muffin, flat bread, jelly and other choices of food before. Also, they always give Resident #109 a lot of food, so she can choose what she wants. On 06/28/23 at 02:06 PM, during a follow up interview with Resident #109, the resident stated, They gave me scrambled eggs this morning. I didn't eat it. I didn't tell them this morning, but I told them before. They still bring it to me. During an interview with Staff C, Licensed Practical Nurse (LPN), on 06/28/23 at 02:12 PM regarding Resident #109's food choices, Staff C stated, the only food she knew that Resident #109 doesn't like is cereal with dry raisins. Staff C stated, she didn't know about Resident #109's egg preferences. Staff C further stated, if a resident doesn't like a food, the resident would tell a CNA or a nurse, then the CNA or the nurse would call the Dietitian to come and talk to the resident to change the resident's food preference. On 06/28/23 at 02:19 PM, the Dietary Director stated, For food preferences, we make notes in the system. I don't know the food preference for breakfast for Resident #109. My Dietitian spoke to her. On 06/28/23 at 02:27 PM while interviewing the Dietitian inside Resident #109's room regarding food preferences, Resident #109 stated, I spoke to her (Dietitian) about the eggs. That time, I told her that I wanted salt. Since then, I've been getting fried or scrambled eggs. They used to give me Page 1 of 3 105172 105172 06/29/2023 Fountain Manor Health & Rehabilitation Center 390 NE 135th St North Miami, FL 33161

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few boiled eggs before, but after I talked to her, I've only been receiving fried or scrambled eggs. I don't eat them. It's a waste. I never tell them I want scrambled or fried eggs. I only asked to send me some salt with the egg. On 06/28/23 at 02:28 PM, the Dietitian stated, I think it was a miscommunication. Yes, I spoke to her, and she told me about the salt. I thought she told me she did not want the boiled eggs anymore; that's right her preference is fried or scrambled eggs right now. Review of Resident #109's Care Plan dated 02/23/2023 regarding food preferences revealed, Provide nutritional supplements as ordered; offer snacks and/or supplements as ordered; offer alternatives if the main meal is disliked; update food preferences PRN (Pro Re Nata meaning as necessary); provide diet as physician ordered. Review of Resident #109's food preference labeled Cart 5 revealed: Breakfast: General regular, coffee, grits or cold cereal - no raisin, eggs - fried or scrambled, salt. Dislike: Oatmeal mexin casserole Lunch: General regular, coffee Dislike: Oatmeal mexin casserole Dinner: General regular, coffee Dislike: Oatmeal mexin casserole On 06/28/23 at 03:48 PM, the Dietary Director brought a new food preference menu with Resident #109's name written on top. She stated, Resident #109's food preference has been updated. From now, she will receive boiled eggs instead of fried eggs. Here is the change. Review of Resident #109's food preference Cart 5 revealed, fried or scrambled eggs on the menu were replaced by 2 hard-boiled eggs. Review of the facility's resident food preferences policy, titled, Food preference interpretation and statement revealed: Individual food preferences will be assessed upon and communicated to the interdisciplinary team. Modifications to diet will only be ordered with the resident's food and eating preferences in the care plan. 1. Upon the resident's admission (or within twenty-four (24) hours after his/her admission) the Dietitian or nursing staff will identify a resident's food preferences. 2. When possible, staff will interview the resident directly to determine current food preferences based on history and life patterns related to food and mealtimes. 3. Nursing staff will document the resident's food and eating preferences in the care plan. 105172 Page 2 of 3 105172 06/29/2023 Fountain Manor Health & Rehabilitation Center 390 NE 135th St North Miami, FL 33161

F 0550 Level of Harm - Minimal harm or potential for actual harm 11. The facility's quality assessment and performance improvement (QAPI) committee will periodically review issues related to food preferences and meals to try to identify more widespread concerns about meal offerings, food preparation, etc. Residents Affected - Few 105172 Page 3 of 3