F 0810
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
Level of Harm - Minimal harm
or potential for actual harm
Based on observation, interviews and policy review, the facility failed to ensure adequate and appropriate
utensils were provided for resident meals. This affected seven residents (#1, #3, #13, #14, #19, #43, and
#44) of seven residents reviewed for appropriate eating utensils being provided with meals. This had the
potential to affect all 45 residents who received meals from the kitchen. The facility census was 45. Findings
include: Observation on 01/22/26 at 8:14 A.M. revealed two Certified Nursing Assistants (CNAs) passing
resident meal trays. Observation of the resident breakfast trays being passed by the CNA staff revealed
only a metal spoon was present on each tray and there were no additional silverware or utensils present on
the tray or offered to the residents. Observation on 01/22/26 at 8:23 A.M. revealed Dietary Aide (DA) #277
pushing an open cart containing approximately 15-20 meal trays that only had a plastic spoon sitting on top
of a folded brown paper towel next to the covered plate.Interview on 01/22/26 at 8:25 A.M. with DA #277
revealed they did not have enough metal silverware for all the residents, so they sent plastic silverware to
the remaining residents.Interview on 01/22/26 at 8:30 A.M. with DA #263 confirmed there was not enough
silverware for all resident meal trays, so plastic silverware was used for at least half of the residents' trays
for each meal. DA #263 additionally stated the kitchen had been out of napkins since 01/20/26 and had
been using folded brown paper towels from the hand towel dispenser. DA #263 mentioned the facility
sometimes ran out of juice cups for the residents and but there had been a shortage of silverware/utensils
for at least six months.Review of the facility lunch menu for 01/22/26 revealed the lunch menu consisted of
a chicken enchilada, Spanish rice, corn and black beans, a banana, and juice or milk.1. Review of the
medical record for Resident #1 revealed an admission date of 10/02/25. Diagnoses included but were not
limited to chronic obstructive pulmonary disease, chronic congestive heart failure, and type II diabetes
mellitus. Resident #1 was noted to be cognitively intact, received a no concentrated sweets diet, and
required set up for meals.Interview on 01/22/26 at 12:19 P.M. with Resident #1 revealed frequently he only
receives a spoon, had previously received only a fork to eat soup with, and frequently received plastic
silverware with meals. Observation at the time of the interview revealed Resident #1 had only a metal
spoon on the lunch tray. 2. Review of the medical record for Resident #3 revealed an admission date of
02/17/25. Diagnoses included but were not limited to dementia, peripheral vascular disease, and atrial
fibrillation. Resident #3 was noted to be cognitively intact, received a regular diet, and required set up for
meals. Interview on 01/22/26 at 12:25 P.M. with Resident #3 revealed the resident sometimes only a spoon,
and sometimes it was a plastic utensil. Observation at the time of the interview revealed Resident #3 only
had a metal spoon on the lunch tray. 3. Review of the medical record for Resident #13 revealed an
admission ate of 11/10/25. Diagnoses included but were not limited radiculopathy of the lumbar region,
alcohol abuse and chronic post-traumatic stress disorder. Resident #13 was noted to be cognitively intact,
received a regular diet, and was independent for eating.Interview on 01/22/26 at 12:43 P.M. with Resident
#13 revealed he
Residents Affected - Some
(continued on next page)
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:
365859
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
365859
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/27/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
The Merriman
209 Merriman Rd
Akron, OH 44303
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)
F 0810
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
received plastic utensils for about half of his meals. Observation at the time of interview revealed Resident
#13 had only a metal spoon on the lunch tray.4. Review of the medical record for Resident #14 revealed an
admission date of 06/04/25. Diagnoses included but were not limited to chronic obstructive pulmonary
disease, type II diabetes mellitus, and bipolar disorder. Resident #14 was noted to have intact cognition,
received a regular mechanical soft diet, and required set up for meals.Interview on 01/22/26 at 12:34 P.M.
with Resident #14 revealed the resident received plastic utensils at least once a week. Observation at the
time of the interview revealed Resident #14 had only a metal spoon on the lunch tray.5. Review of the
medical record for Resident #19 revealed an admission date of 12/12/25. Diagnoses included but were not
limited to bipolar disorder with severe depression, type II diabetes mellitus, and hemiplegia and
hemiparesis. Resident #19 was noted to be cognitively intact, received a carbohydrate-controlled diet, and
was independent for eating. Interview on 01/22/26 at 12:38 P.M. with Resident #19 revealed the resident
usually received plastic silverware, had previously only received a spoon to eat meat with, and had to eat it
with his fingers. Resident #19 stated there were times no utensils had been sent with the meal tray.
Observation at the time of the interview revealed Resident #19 had only a metal spoon on the lunch tray. 6.
Review of the medical record for Resident #43 revealed an admission date of 04/24/23. Diagnoses included
but were not limited to anxiety disorder, other psychoactive substance abuse, and severe protein-calorie
malnutrition. Resident #43 was noted to be cognitively intact, received a regular diet, and was independent
for eating. Interview on 01/22/26 at 12:10 P.M. with Resident #43 revealed sometimes he only received a
spoon with which to eat items such as salad. Resident #43 stated he sometimes received plastic utensils
and occasionally does not receive utensils at all with the meal. Observation at the time of the interview
revealed Resident #43 had only a metal spoon on the lunch tray.7. Review of the medical record for
Resident #44 revealed an admission date of 03/16/18. Diagnoses included but were not limited to
hemiplegia and hemiparesis following cerebral infarction, epilepsy, and anxiety disorder. Resident #44 was
noted to have moderate cognitive impairment, received a carbohydrate-controlled diet, and required set up
for meals.Interview on 01/22/26 at 12:06 P.M. with Resident #44 revealed he does not always receive
silverware with meals and frequently received plastic utensils with the meal tray. Observation at the time of
the interview revealed Resident #44 had only a metal spoon on the lunch tray.Interview on 01/26/26 at 1:26
P.M. with the Administrator confirmed residents should receive the appropriate silverware for all
meals.Review of the undated facility policy called; Use of Disposable Dishes/Flatware revealed resident
meals shall be served using reusable dishes and flatware.This deficiency represents non-compliance
investigated under Complaint Number 2693876.
Event ID:
Facility ID:
365859
If continuation sheet
Page 2 of 2