Health inspection·November 3, 2022

F 0803 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 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 medical record review, observation, staff interview, review of the recipes, review of the menu spreadsheet, and policy review, the facility failed to provide puree foods as planned by a Registered Dietitian. This affected two residents (#27 and #35) out of three residents reviewed for puree food diets. The facility census was 76. Findings Include: 1. Review of the medical record revealed Resident #27 was admitted to the facility on [DATE]. Diagnoses included bone necrosis of the mouth gums, dysphagia and gastro-esophageal reflux disease. Review of the Minimum Data Set (MDS) comprehensive assessment dated [DATE] revealed the resident had moderately impaired cognition and received puree thin liquid diet. 2. Review of the medical record revealed Resident #35 was admitted to the facility on [DATE]. Diagnoses included dysphagia, Parkinson's disease, hypothyroidism, and atrial fibrillation. Review of the MDS comprehensive assessment dated [DATE] revealed Resident #35 had intact cognition and received pureed foods with nectar thick liquids diet. Review of the puree soup recipe revealed the puree soup should be served using a six ounce ladle. Review of the puree meat recipe revealed the puree meat should be served using a number 12 scoop. Review of the menu spreadsheet dated 11/02/22 revealed the puree lunch meal consisted of one portion of puree meat, puree soup size six ounces, puree starch of a formed mold, puree carrots of a mold form and pudding one half cup. Observation 11/02/22 from 12:25 P.M., to 1:00 P.M. revealed Diet Server (DS) #410 used number eight scoop for the pureed meat portion, and used the number 12 scoop for the puree soup. There was no molded form starch food. Observation on 11/02/22 at 12:25 P.M., Resident #35 had not received the puree pudding. Resident #27's meal plate was covered and ready to serve when the surveyor asked DS #410 of the missing puree vegetable. Interview on 11/02/22 at 12:45 P.M., DS #410 verified he had not used the correct serving utensil (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 4 Event ID: 366023 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 366023 B. Wing A. Building (X3) DATE SURVEY COMPLETED 11/03/2022 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Twin Towers 5343 Hamilton Avenue Cincinnati, OH 45224 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)