Health inspection·December 12, 2019

F 0679 Provide activities to meet all resident's needs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to provide Resident #42 with activities that met his preferences and psychosocial needs. This affected one resident (Resident #42) out of 27 residents interviewed regarding activities. Residents Affected - Few Findings include: Medical record review revealed Resident #42 was admitted to the facility on [DATE] with diagnoses including major depressive disorder and dementia without behavioral disturbances. Review of the annual Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #42 was cognitively intact and independent in daily decision making, and it was very important to Resident #42 to do activities with groups of people, to participate in favorite activities, and to go outside to get fresh air when the weather permitted. Review of the activity assessment dated [DATE] indicated Resident #42's current activity pursuits/interests included shopping and outdoors. It was additionally noted he enjoyed visiting his wife, Bingo, football pool and shopping at the local department store. Review of the activity plan of care revised on 10/14/19 indicated he would benefit from a variety of programs to help maintain his current functional abilities. The interventions included documenting attendance/refusals, encouraging him to attend, praising attendance and providing him a monthly calendar. Although the plan was revised, it lacked inclusion of Resident #42's preferences or interventions to meet his activity needs. Interview of Resident #42 on 12/09/19 at 1:35 P.M. revealed Resident #42 was very disappointed and disheartened that the facility had decided not to continue dine in (lunch brought to the facility from area restaurants monthly) each month from November until March. The facility had also chosen to discontinue outings to an area department store from November until March. Resident #42 was told the food gets too cold when it was brought in for lunch, and there was not enough staff for the outings. Interview of Assistant Activities Director (AAD) #502 on 12/11/19 at 8:14 A.M. revealed the dine in was only from March through October because a staff member fell in the snow and was injured. AAD #502 confirmed that the residents would like to have dine in all year, and Resident #42 had also requested that it continue all year. Interview of Activities Director #501 on 12/11/19 at 8:34 A.M. revealed field trips were from March through October for safety reasons, and dine in was March through October. AD #501 stated that the Page 1 of 3 365072 365072 12/12/2019 Anna Maria of Aurora 889 North Aurora Road Aurora, OH 44202

F 0679 Level of Harm - Minimal harm or potential for actual harm program was new and having area restaurants deliver food during the winter months was something she had not thought of but would consider. AD #501 stated that field trips required a lot of effort to plan and additional staff members needed to be scheduled so that there were six staff for ten residents on the bus. Residents Affected - Few 365072 Page 2 of 3 365072 12/12/2019 Anna Maria of Aurora 889 North Aurora Road Aurora, OH 44202

F 0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to ensure room trays were served at appetizing temperatures. This affected three of three residents (Residents #46, #76, and #35) who complained of food temperatures and ate meals in their rooms on the North Unit. Residents Affected - Few Findings include: Interviews on the North unit on 12/09/19 from 9:56 A.M. through 2:57 P.M. with Residents #46, #76, and #35 revealed concerns related to receiving hot foods served at cold temperatures. Observation of tray line on the North unit on 12/10/19 at 11:45 A.M. with Foodservice Worker (FW) #200 revealed the following food temperatures: corn-167 degrees Fahrenheit (F), spinach 177 degrees F, mechanical chicken 187 degrees F, chicken 165 degrees F, cream of chicken 168 degrees F, salmon 177 degrees F. FW #200 stated room trays were served room by room after the dining room was served. A test tray was completed on 12/10/19 at 12:38 P.M. after last room tray was served with FW #200. The chicken was 136 degrees F and tasted hot, palatable, and was easy to chew. The spinach was 114 degrees F and was cool to taste but palatable. The corn was 119 degrees F and was cool to taste but palatable. Interview at this time with FW #200 verified the corn and spinach tasted cool. Interview on 12/10/19 at 12:54 P.M. with FW #200 revealed that there was typically three to four residents who ate in their room on the North unit. Review of the undated facility policy titled Policy and Procedure Conducting Test Trays, revealed test trays would be completed at least once monthly at breakfast, lunch, or dinner meal service. Additional test trays would be completed as needed based on patient complaints about cold food. The purpose was to assure meal trays were delivered to residents in a timely manner, assuring food was at the proper temperature and quality when it was served to the patient. 365072 Page 3 of 3