Inspection·May 9, 2022

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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review, observation, staff interview, and policy review, the facility failed to ensure the residents were treated with dignity and respect at meal service. This affected one (Resident #120) of 11 residents whom were eating lunch in the dining room. The facility census was 148. Findings include: Record review for Resident #120 revealed Resident #120 was admitted on [DATE]. Diagnoses included congestive heart failure, diabetes mellitus, hypertension, obesity, chronic kidney disease, and anemia. Review of the five-day Medicare Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #120 had no cognitive deficits and required supervision during eating. Observation of lunch service on 05/02/22 from 12:15 P.M. to 12:45 P.M. revealed State Tested Nursing Assistant (STNA) #46 brought Resident #120 into the dining room and placed Resident #120 at the table with Resident #20. Resident #20 was served her lunch at 12:15 P.M. and STNA #46 continued to serve the other nine residents (#14, #25, #31, #35, #41, #48, #59, #124, and #149) in the dining room and then started to set up room trays while Resident #120 was still waiting for her tray. Interview on 05/02/22 at 12:45 P.M. with STNA #46 verified Resident #120 had not been served her lunch and STNA #46 explained she had been forgotten. STNA #46 stated she went into the kitchenette and found Resident #120's meal ticket tucked under a tray and that was why she was forgotten. Review of the facility's Meal Service Policy, dated 05/2021, revealed the Registered Dietician/RD and nursing personnel will assist with the dining room seating charts for each unit. The charts will identify where the residents will be served and help ensure the delivery of the appropriate diet. It also assures that each resident at any given table is served before moving onto the next table, and all residents at one table will be served before moving to the next table. If a resident sits at a table where the tablemates are already eating, his/her tray will be obtained as quickly as possible. This deficiency substantiates Complaint Number OH00114887 and OH00113637. Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 365772 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 365772 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/09/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Eastgate Health Care Center 4400 Glen Este Withamsville Road Cincinnati, OH 45245 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)