Health inspection·May 14, 2025

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 record review, photographs of meals & tray ticket review, and interview, the facility failed to follow Resident #90's meal preferences. This affected one resident (Resident #90) of four residents reviewed for preferences. The census was 68. Findings include: Review of the closed medical record for Resident #90 revealed an admission date of 04/18/25 and a discharge date of 05/09/25. Resident #90's diagnoses included diabetes, end stage renal disease and major depression disorder. Review of the 5-day admission Minimum Data Set (MDS) dated [DATE] revealed Resident #90 was cognitively intact. She required set up assistance with meals. Review of the Nutrition Data Collection/Evaluation dated 04/23/25 revealed Resident #90 had carrots listed as one of her dislikes. Review of the undated Meal Tracker printout, revealed carrots were listed as a dislike among several other dislikes for Resident #90. The printout stated her diet was updated on 04/23/25. Review of photographs provided by Resident #90's family revealed four photographs of meals with tray tickets with the plated meal. On 04/28/25 the lunch ticket listed brussel sprouts selected as the vegetable to be served and the photograph showed carrots were served. On 4/28/25 the dinner ticket listed whole kernel corn to be served as the vegetable and the photograph showed carrots were served. On 04/30/25 the lunch ticket listed brussel sprouts as the selected vegetable and the photograph revealed the selection was not served. On 05/02/25 the lunch ticket listed broccoli florets selected as the vegetable and the photograph showed carrots were served. Interview on 05/13/25 at 7:30 P.M. with Resident #90's family member revealed Resident #90 was not provided meals according to her preference and the photos supported this. Interview on 05/14/25 at 12:00 P.M. with the District Director of Dietary and at 3:15 P.M. with the Director of Nursing revealed they reviewed the photographs of meals with tray tickets and verified Resident #90 received food items listed on her dislike list for three of the meals. Review of the facility policy titled Dining and Food Preferences, revised 10/2022 revealed individual dining, food, and beverage preferences are identified for all residents. The individual tray Page 1 of 2 365718 365718 05/14/2025 Arbors at Streetsboro 1645 Maplewood Dr Streetsboro, OH 44241

F 0806 Level of Harm - Minimal harm or potential for actual harm assembly ticket will identify all food items appropriate for the resident based on diet order, allergies & intolerances, and preferences. The photographs were viewed and verified on 05/14/25 by both the Regional Director of Dietary at 12:00 P.M. and the Director of Nursing on 3:15 P.M. This deficiency represents non-compliance investigated under Complaint Number OH00165632. Residents Affected - Few 365718 Page 2 of 2