Health inspection·December 14, 2023

F 0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review the facility failed to provide palatable meals and failed to ensure food was served at adequate temperatures. This had the potential to affect all residents residing in the facility. The facility census was 151. Residents Affected - Many Findings include: Interviews on 12/13/23 from 9:18 A.M. to 9:55 A.M. with Resident #128 and Resident #14 revealed their meals were cold at times. Interview on 12/13/23 at 3:11 P.M. with Resident #141 revealed his meals were almost always cold, including his soups and coffee. Interview 12/13/23 at 3:16 P.M. with State Tested Nursing Assistants (STNAs) #208 and #210 revealed they were aware of multiple concerns related to cold foods. Interview on 12/13/23 at 3:20 P.M. with Resident #109 revealed his food was often cold. Resident #109 stated his family often provided him with food, and he had a microwave in his room to heat the food his family brought. Resident #109 stated, If it wasn't for my family, I would starve. Observation of meal service on 12/13/23 beginning at 4:45 P.M. revealed a pan of cut up chicken that was in chicken broth, a pan of cooked hamburgers that appeared to be old and dry, and a pan of golf ball sized dinner rolls that appeared to be dry and hard. Interview with Supervisor of Dining Services (SDS) #212 revealed meal plating usually began about 4:30 P.M. and she stated she had already obtained the temperatures of the food. Observation revealed a clipboard with no recorded temperature for the chicken or hamburgers, a temperature of 195 degrees Fahrenheit (F) for the soup, and the salad temperature of 35 degrees F. SDS #212 stated she had not written down the temperatures of the chicken; however, it was 183 degrees F, and she had not taken the temperature of the hamburgers or the pureed items. SDS #212 stated she was aware of concerns related to food temperatures and taste. A test tray was requested at 5:33 P.M. and was plated at 6:08 P.M., test tray consisted of a hamburger with a piece of unmelted cheese, French fries, and a bowl of soup. Test tray arrived to the floor at 6:12 P.M. and was received at 6:28 P.M. after the last resident tray was served. The temperature of the cheeseburger was 95 degrees F, French fries were 80 degrees F, and soup was 97 degrees F. Temperatures were verified by STNA #211. The test tray food was cold and lacking taste. Review of Resident Council Minutes for September and October 2023 revealed concerns related to cold food. This deficiency represents non-compliance investigated under Master Complaint Number OH00148622. Page 1 of 2 366071 366071 12/14/2023 MT Alverna Home Inc 6765 State Road Parma, OH 44134

F 0809 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. Based on observation, record review, and interview the facility failed to ensure timely meal service. This had the potential to affect all residents residing in the facility. The facility census was 151. Findings include: Review of the mealtime schedule revealed breakfast was served from 7:30 A.M. to 9:00 A.M., lunch was served from 12:00 P.M. to 1:00 P.M., and dinner was served from 5:00 P.M. to 6:30 P.M. Interviews on 12/13/23 from 9:18 A.M. to 9:55 A.M. with Resident #128 and Resident #14 revealed their meals were often late. Interview on 12/13/23 at 3:11 P.M. with Resident #141 revealed his meals were almost never on time. Interview on 12/13/23 at 3:16 P.M. with State Tested Nursing Assistants (STNAs) #208 and #210 stated they worked from 7:00 A.M. to 7:00 P.M., and meals were often late. STNAs #208 and #210 stated there were occasions when the dinner meals were not served until between 6:30 P.M. and 6:45 P.M. Interview on 12/13/23 at 3:20 P.M. with Resident #109 revealed his meals were always late. At time of interview STNA #211 entered Resident #109's room to take his dinner order and stated the meals were always late. STNA #211 stated the dinner meals were served between 6:30 P.M. and 7:00 P.M. at times. Interview on 12/13/23 at 4:45 P.M. with Supervisor of Dining Services (SDS) #212 revealed meal plating usually began about 4:30 P.M.; however, the meal was behind today due to the lettuce she was going to use spoiled, and she had to cut new lettuce. SDS #212 stated meals were late on occasion. Dishwasher #213 stated on 12/12/23, he and SDS #212 were the only staff members present to prepare the meals. Observation on 12/13/23 at 6:42 P.M. revealed dinner trays were continuing to be served on the first floor. This deficiency represents non-compliance investigated under Master Complaint Number OH00148622. 366071 Page 2 of 2