Health inspection·November 16, 2022

F 0806 Level of Harm - Minimal harm or potential for actual harm Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. Based on observation, interview and record review, the facility failed to assess the individual food preferences for 2 (R13 and R74) of two residents reviewed for food preferences in the sample of 42. Residents Affected - Few Findings include: 1. R13's Face Sheet documented an admission date of 09/27/22. R13's November 2022 Physician Order Sheet documented an order for regular diet with regular consistency and thin liquids. R13's Dietician Progress Notes for 09/29/22, 11/03/22, and 11/10/22 documented weight loss with interventions to address weight loss, however contained no documentation as to R13's food preferences. There was no documentation in any of R13's dietary notes about R13's food preferences. On 11/14/22 at 12:16pm, R13 was alert and oriented to person and place. R13 got the month and year right but the date wrong. R13 stated R13 hates the food the facility serves R13. R13 stated R13 eats the same thing, a grilled cheese sandwich and/or chicken noodle soup, every day for lunch and dinner. R13 stated R13 always eats in R13's room. There was an untouched dish of beets on R13's tray. R13 stated, I don't know why they keep sending me this crap I don't like. R13 stated staff have never asked R13 what kinds of foods R13 likes. R13 stated staff has not explained to R13 what foods are always available. On 11/14/22 at 12:45pm, V4 (Certified Nursing Assistant/CNA) stated R13 is a picky eater who will only eat grilled cheese and chicken noodle soup. On 11/15/22 at 9:30am, V3 (Dietary Manager) stated it is her responsibility to interview residents about their food preferences and to document them within the Dietary Progress Notes. V3 stated she has not yet had an opportunity to assess or discuss food preferences with R13. V3 stated she does know R13 requests chicken noodle soup and grilled cheese daily. On 11/15/22 at 12:08pm, R13 was eating lunch in R13's room. R13 was eating two bowls of chicken noodle soup, without a grilled cheese. R13 stated R13 was not in the mood for grilled cheese today. R13 stated R13 always orders biscuits and gravy for breakfast. R13 stated R13 likes bacon and would eat it if served to R13, but it is not served very often and R13 is not sure if R13 can request it. R13 stated R13 likes fried eggs but the facility only serves poached or scrambled eggs. R13 stated nobody has ever asked R13 how R13 prefers R13's eggs. 2. R74's Face Sheet documented an admission date of 09/18/22. R74's November 2022 Physicians Order Page 1 of 2 145841 145841 11/16/2022 Parkway Manor 3116 Williamson County Parkway Marion, IL 62959

F 0806 Sheet documented an order for regular diet, regular consistency, and thin liquids. Level of Harm - Minimal harm or potential for actual harm R74's Dietician Assessments dated 09/22/22, 10/13/22 and 11/10/22 documented weight loss with interventions to address weight loss, however contained no documentation as to R74's food preferences. There was no documentation in any of R74's dietary notes about R74's food preferences. Residents Affected - Few On 11/14/22 at 11:57am, R74 was observed in her room with V5 (Family Member). R74 was alert and oriented to person and place but not time. R74 was eating a restaurant catfish meal brought in for her by V5. R74 stated she does not really like foods the facility serves her. R74 stated today she asked staff to not bring in a tray as she did not like any of the foods offered today. On 11/15/22 at 9:38am, V3 stated she has not had an opportunity to speak with R74 about her food preferences, but that V5 had called V3, concerned about R74's intakes and her weight. V3 stated she recalls V5 stated R74 likes fish and pasta. On 11/15/22 at 11:50am, R74 was in her room with V5, eating a restaurant fried chicken meal V5 brought her. V5 stated R74 did not like the foods the facility served her so V5 decided to start bringing food in for R74. V5 stated he called V3 to tell V3 about R74's food preferences, for example, R74 absolutely will not eat cheese. V5 stated he has noted R74 is frequently served foods containing cheese even after this conversation. R74 stated for breakfast this morning, she was served a cheese omelet. R74 stated she did not eat it and did not request a substitute, but would have eaten plain scrambled eggs had they been offered to her. R74 stated the lunch meal today was Some kind of casserole-I told them not to bother to bring it in here. R74 stated she did not recall hearing anything about some foods always being available. An undated Always Available Menu Policy documented, The Food Service Supervisor (Dietary Manager) is to work with the residents family/friends/DPOA (Designated Power of Attorney) as well as (to) utilize direct meal observations and meal intakes to discern usual beverage, bread, and other specific meal preferences. The Always Available Menu items on this document included: Hamburger on Bun, Cheeseburger on Bun, Meat Salad Sandwich, Deli Meat and Cheese Sandwich, Fried Egg Sandwich, Grilled Cheese Sandwich, Peanut Butter and Jelly Sandwich, and Chef Salad with 2 ounces of Meat and Cheese and 1 Hard Boiled Egg. 145841 Page 2 of 2