Health inspection·October 6, 2023

F 0806 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and records review, the facility failed to follow their policy on resident food preferences for one (R6) of four residents reviewed. Findings include: R6 is a [AGE] year-old individual, admitted to the facility on [DATE]. R6's medical diagnoes include but are not limited to Type 2 Diabetes Mellitus with Diabetic Neuropathy, unspecified, and mixed hyperlipidemia. R6's BIMS (Brief Interview for Mental Status) Score, dated [DATE], documents R6's score as 15/15, indicating R6's cognation is intact. On 10/05/2023 on 10:00am, R6 said she does not get her boiled egg each morning, which she prefers, despite requesting for it each day. R6 further stated she has received the boiled egg only once, and even today she did not receive one. On 10/05/2023 10:55am, V5(Food Services Director) said she met R6 about two weeks ago, and R6 told her of her food preferences, including boiled egg/s for breakfast, no sweeteners, no canned foods. V5 said today's breakfast was baked egg with cheese and sausage. V5 showed surveyor R6's meal ticket. On the breakfast ticket, breakfast was listed as: Sausage Egg & Cheese baked, Assorted Mini Danish, Grits, Whole Milk, Hot Coffee, or Hot Tea. V5 said the boiled egg was not listed on the breakfast ticket, therefore, the line servers would not know R6 prefers boiled eggs, therefore, it was not served to R6. V5 said there were boiled eggs in the kitchen fridge. Surveyor with V5 toured the kitchen fridge and observed five crates of eggs, with each crate holding 30 eggs. V6 said R6 should have received a boiled egg at breakfast time, and further commented, It was my mistake that I did not correct her ticket and put the boiled egg/s in when she (R6) told me that she would like boiled egg/s for breakfast. On 10/04/2023 11:18am, V21 (Registered Dietitian) each resident is offered their food preferences and given options to choose form, to encourage residents to eat their meals to meet their nutritional needs. V21 said kitchen staff are responsible for monitoring resident meal tickets to make sure residents receive their preferred/prescribed diet/meals. On 10/05/2023 11:15am, V1(Administrator) said when the resident comes to the facility, the food services manager meets with the resident to discuss the resident's food preference, and the meal ticket is updated so the resident can get their preferred food. V1 further said if the resident's food preference is not put on the meal ticket, and the resident will not get their preferred food. Page 1 of 2 145875 145875 10/06/2023 Warren Barr Lincoln Park 2732 North Hampden Court Chicago, IL 60614

F 0806 Level of Harm - Minimal harm or potential for actual harm On 10/05/2023 at 12:15pm, V29(Culinary Development Specialist) said, Food preferences are offered to residents because the facility wants the residents to enjoy their food and meet their dietary needs, and to create a homelike environment because the facility is their home. If a resident is not provided their preferred foods, it can make resident unhappy. (R6) should have received the boiled egg because it does not affect her diet. It is just that the boiled egg/s was not included in her meal ticket. Residents Affected - Few R6 diet is documented in R6's Electronic Medical Record as CCHO (Consistent Carbohydrates) diet, Regular texture, Thin liquids consistency Dietitian note, dated 10/1/202,3 documents: provide R6 food preferences, provide foods from alternative menu, provide assistance as needed. Policy titled Dinning and Food Preferences, dated October 2019 documents; -Food Preference Interview will be entered into the medical record. -Food allergies, food intolerance, food dislikes, and food and fluid preferences will be entered into the resident profile in menu management software system. 145875 Page 2 of 2