Health inspection·January 5, 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. Based on record review, observation, resident interview, staff interview, review of the facility menu, and review of the food committee minutes the facility failed to ensure meals, snacks and alternate menu items were offered and provided to the residents per their preferences and requests. This had the potential to affect all the residents residing at the facility who received food prepared in the kitchen. The facility census was 42. Findings include: Review of the medical record for Residents #5 revealed an admission date of 06/16/23 with diagnoses including chronic obstructive pulmonary disorder, type two diabetes mellitus, obesity, borderline personality disorder and schizoaffective disorder. Review of the January 2024 physician orders for Resident #5 revealed the resident was ordered a regular diet with regular texture and thin liquids and double portions. Review of the quarterly Minimum Data Set (MDS) assessment for Resident #5 dated 11/17/23 revealed the resident was cognitively intact and required set-up help only for meals. Resident #5 had no problems with chewing or swallowing, no weight loss and no identified dental problems. Review of the admission dietary assessment for Resident #5 dated 08/02/23 revealed the resident preferred to eat in the dining room for three meals a day and a snack between meals. Raw onions were listed as a disliked item for Resident #5 but there was no additional information noted regarding the resident's dietary likes or dislikes. Review of the nutritional assessment for Resident #5 dated 11/3/23 revealed it did not include documentation regarding the resident's dietary likes or dislikes. Review of the care plan for Resident #5 dated 07/13/23 revealed the resident had a potential for alteration in nutrition and hydration related to chronic diseases such as chronic obstructive pulmonary disorder, diabetes mellitus, borderline personality disorder, hypothyroidism and schizoaffective disorder. Interventions included the following: assist with meals as needed, provide double portions, honor food preferences as able, medications as ordered, monitor for signs and symptoms of dehydration, offer alternative fluid options, offer meal alternate if resident refuses meal, provide diet as ordered, refer to dietitian as needed, obtain weights as ordered. Interview on 01/04/24 at 12:47 P.M. with Resident #5 confirmed no one from the facility had asked him about his dietary likes and dislikes. Resident #5 stated he received a copy of the monthly menu, Page 1 of 3 366130 366130 01/05/2024 Riverside Landing Nursing and Rehabilitation 856 South Riverside Drive McConnelsville, OH 43756

F 0803 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many but it had not changed since the summer. The alternate menu had the same items on it since he arrived in June 2023 which included the following items: hot dog, hamburger, peanut butter and jelly sandwich, chicken strips, and grilled cheese. Resident #5 stated if he asked for anything different, he was told that the alternate menu items was all the kitchen had. Resident #5 stated during the food committee meetings, the residents had asked for a different variety of items for meals, alternate menu items and snacks such as fresh fruit, pizza, ice cream, salad, cold cut sandwiches, soup and popcorn. Resident #5 stated he loved bologna, but it was not available to him. Resident #5 stated the snacks left at night included extra food or leftovers from lunch and dinner, peanut butter and jelly half sandwiches, an oatmeal type granola bar, and sometimes a small bag of chips or a cookie. Resident #5 stated the kitchen was locked at night and the staff will could not obtain anything to eat or drink that was not on the snack tray in the refrigerator. Resident #5 stated he had talked with the Administrator, the Ombudsman and dietary services about his requests for more variety, but nothing had changed. Observation on 01/04/24 at 12:55 P.M. of the lunch meal served in the dining room revealed Resident #5 was served two plates of food. Each plate had a hamburger, a side dish of creamed corn and two mashed potato pierogies. Review of the meal ticket on the tray for Resident #5 revealed it listed the resident's diet orders but did not include the resident's dietary likes or dislikes. Interview on 01/04/24 at 12:55 P.M. with Resident #5 confirmed he ordered the hamburgers from the alternate menu before 10:00 A.M. Interview on 01/04/24 at 1:06 P.M. with Resident #28 confirmed the resident ordered from the alternate menu often as the food here was not what he liked. Resident #28 stated the menu repeated monthly for six months. The alternate menu had the same five items since he arrived at the facility. Resident #28 stated the facility staff had not asked him about his likes or dislikes. Resident #28 stated he requested cottage cheese, fresh fruit and a tuna fish sandwich and was told the kitchen did not have those items on hand. Resident #28 stated snacks were leftovers from the day's meals. Resident #28 stated he attended the food committee meeting a few times, but it did not change the menus or snacks. Interview on 01/04/24 at 1:22 P.M. with Resident #32 confirmed he had lived at the facility for a few years, and the menus had been the same even though they changed every six months. Resident #32 confirmed he did not recall anyone asking him what he likes to eat or doesn't like to eat. Resident #32 stated the alternate menu items were always the same, and he got tired of the same things. Resident #32 confirmed he would like to have a bologna sandwich, chicken salad sandwich, fruit, ice cream or soup, but the kitchen did not keep those things on hand. Resident #32 stated the snacks at night were the same things as well. Resident #32 stated the kitchen was locked up at night and the staff did not have a key, and therefore, he was unable to get a glass of milk at night if they ran out from the snack tray. Resident #32 stated the facility did not honor resident choices when it came to meals. Interview on 01/04/24 at 1:44 P.M. with Dietary Manager (DM) #130 confirmed the meal tickets for Residents #5, #28 and #32 did not have the residents' likes or dislikes of food. DM #130 confirmed she was permitted to go to the store and purchase small amounts of cold cuts and other items for the residents that the residents had requested, but she had not done so. Review of the Food Committee meeting minutes dated 10/19/23 revealed the residents discussed the fall menu and wanted a greater variety of food. 366130 Page 2 of 3 366130 01/05/2024 Riverside Landing Nursing and Rehabilitation 856 South Riverside Drive McConnelsville, OH 43756

F 0803 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Review of the Food Committee meeting minutes dated 12/13/23 revealed the residents had requested additional items to be added to the alternate food menu such as cottage cheese, chef salads, and a variety of lunch meats/cold cuts. Review of the Fall/Winter 2023-2024 resident menu provided by the facility revealed the menu repeated six to eight times throughout the six months. Review of the alternate menu revealed the following items were available to be ordered before 10:00 A.M. for lunch and 4:00 P.M. for dinner: hot dog, hamburger, peanut butter and jelly sandwich, chicken strips, and grilled cheese. This deficiency represents non-compliance investigated under Complaint Number OH00149500. 366130 Page 3 of 3