Health inspection·February 9, 2024

F 0803 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of menus, review of food service invoices, observation, and interview, the facility failed to ensure adequate supply of food, post menu's timely, and failed to follow the menu. This had the potential to affect all 64 residents who received meals from the kitchen. The facility census was 64. Findings include: 1. Observation on 02/09/24 at 8:17 A.M., of the resident notification board revealed no evidence the meals for 02/09/24 were posted. The lunch and dinner meals were posted for yesterday 02/08/24. Interview on 02/09/24 at 8:27 A.M., with the Dietary Manager (DM) #58 confirmed he doesn't post breakfast menus and he hasn't posted the lunch and dinner menus yet but was getting ready to. Interview on 02/09/24 at 8:44 A.M., with Resident #10 revealed the kitchen staff don't post breakfast, lunch, or dinner menus on the board timely. The Resident reported she doesn't like meat and if she wanted an alternative, she would have to write her request on paper and place it in the box at the nurse's station by 10:15 A.M. Most of the time the menu isn't posted so she doesn't know what's going to be served to have enough time to place a request for an alternative meal. 2. Observation on 02/09/24 at 8:27 A.M. of the dry storage food with the DM #58 revealed there was 10 cake mixes, two cornbread mixes, six cans of peaches, six can of pudding, six cans of mandarin oranges, six cans of [NAME] sauce, three cans of collards, two cans of bean, two cans of sweet potatoes, one full bag of noodles, two 1/4 bags of noodles, a bag of rice, two bags of dried mashed potatoes, and one box of pancake mixes. There was one box of bread and one box of chips. Further observation revealed no evidence of emergency supply of food. Interview on 02/09/24 from 8:18 A.M. to 8:44 A.M., with Resident #10 and #36 confirmed there was shortage of food. Resident #36 reported there wasn't enough food frequently if you wanted a second serving. Resident #10 reported the food was not nutritious. The kitchen cooks a lot of casseroles to stretch out the meat. The kitchen was on a tight budget and ran out of food frequently. The snacks were not sufficient as well. Last night they only gave them a 1/2 of a jelly sandwich and there was barely any jelly on the sandwich. Interview on 02/09/24 at 8:33 A.M., with two anonymous staff members confirmed there were not enough snacks available for the residents. Page 1 of 3 365933 365933 02/09/2024 Buckeye Terrace Rehabilitation and Nursing Center 140 N State Street Westerville, OH 43081

F 0803 Level of Harm - Minimal harm or potential for actual harm Interview on 02/09/24 at 11:08 A.M. with DM #58 and Corporate Dietary Manager (CDM)#200 confirmed finding of observation. The DM reported he had discarded the emergency food items because they expired but could not provide a date, he discarded the item. The CDM reported he was not aware until this morning the facility did not have an emergency supply of food and he ordered a three-day supply to replenish the emergency food supply that will be delivered today. Residents Affected - Many 3. Review of the menu for week three and four revealed for dinner on Friday was Lasagna, garlic green beans, bread sticks, pudding. Saturday lunch was pork medallions glaze, pineapple, fluffy steamed rice, oriental vegetables, dinner roll, and assorted fruit cup. Saturday dinner was Swedish meatballs, macaroni and cheese, side salad, dinner roll, and cake. Sunday lunch was ham glaze, scalloped potatoes, green bean casserole, dinner rolls, and pie. Sunday supper was cabbage casserole, buttered carrots, dinner rolls, and cookies. Observation on 02/09/24 at 11:08 A.M., of the refrigerator, freezer, and dry storage area with DM #58 and CDM #200 revealed they facility only had 6 lasagna that had 12 portions in each package, which would be 72 servings. During the initial tour DM#58 had reported there were 20 residents who received double portion, which would indicate he would need around 84 servings of lasagna. He did not have the oriental vegetable for Saturday lunch or the dinner rolls. The DM reported he would replace the oriental vegetables with a vegetable blend and the dinner rolls with cornbread. He did not have macaroni and cheese and dinner rolls for Saturday's dinner but reported he would make macaroni and cheese from scratch and replace the dinner rolls with corn bread. He did not have glazed ham, scalloped potatoes, dinner roll, or fruit pie for Sunday's lunch. The DM reported he would replace the ham with chicken, mashed potatoes for the scalloped, and he would make a fruit cobbler in-place of fruit pie. He did not have cabbage casserole or dinner rolls for Sunday's dinner and would make Jonny Marzetti instead and use garlic bread. DM #58 reported he places his order on Fridays, and the food arrives on Tuesday for the entire week's menu. He had not talked to the Dietitian regarding the recent substitution. He had ham, however had to use it to replace the hot dogs that were on the menu for dinner on Thursday. Review of the food service invoice revealed food was ordered on 02/02/24 (Friday) and delivered 02/06/24 (Tuesday). Further review revealed only one box of Lasagna. There was no evidence of oriental vegetables, dinner rolls, scalloped potatoes, fruit pies, scalloped potatoes, or cabbage casserole were ordered. Interview on 02/09/24 at 11:29 A.M., and 12:13 P.M. with CDM #200 revealed he added a food order that will be delivered today for the missing items for the menu for Saturday and Sunday so the DM will not have to substitute those items now. DM #58 reported to the CDM that the residents don't like the cabbage casserole. The CDM reported he provided education to the DM on how he can change the menu to accommodate the resident request. The CDM reported he would be monitoring the food orders to ensure food was being ordered per the menu and to ensure the facility had an adequate supply of emergency food. He also recommended that the DM meet with the dietitian weekly to discuss alternatives if needed. Interview on 02/09/24 at 2:46 P.M., with Former Resident #1's sister revealed the facility did not have adequate supply of food and her sister didn't not get a dinner meal four times. Staff told her to eat out of the vending machine. Once she was visiting there was another male resident who did not receive a dinner tray and she had to give him money to buy food from the vending machine. 365933 Page 2 of 3 365933 02/09/2024 Buckeye Terrace Rehabilitation and Nursing Center 140 N State Street Westerville, OH 43081

F 0803 This deficiency represents non-compliance investigated under Complaint Number OH00150499. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many 365933 Page 3 of 3