Health inspection·August 3, 2023

F 0809 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 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 review of meal times, observations, staff interviews, and resident interviews, the facility failed to ensure nourishing snacks were offered to residents at bedtime. This had the potential to affect 40 (#10, #12, #14, #18, #20, #22, #26, #28, #40, #41, #42, #43, #44, #45, #46, #47, #48, #49, #51, #52, #53, #54, #55, #56, #57, #58, #59, #60, #61, #62, #63, #64, #65, #66, #67, #68, #69, #70, #71, and #72) out of 41 residents on the 200 unit who receive meals from the kitchen. Resident #50 was identified by the facility as not receiving meals from the kitchen. The census was 53. Findings include: Review of the 200 unit meal times revealed dinner was served at 5:00 P.M. and breakfast was served at 8:00 A.M. There was 15 hours between dinner and breakfast. Interview on 08/02/23 at 9:49 A.M. with State Tested Nursing Assistant (STNA) #104 revealed there was a snack cart created between lunch and dinner, and the dietary department puts snacks in the kitchenette of unit 200. Interview on 08/02/23 at 10:21 A.M. with the Dietary Manager (DM) #100 revealed there were snacks available throughout the day for the residents. DM #100 indicated she fills the kitchenette on the 200 unit daily. DM #100 indicated there were sandwiches, multiple types of crackers, chips, and fruit which were always available. If the staff needed anything else then they could ask her. She indicated she checks daily before leaving the facility to ensure the second shift has enough snacks on the 200 unit and the skilled unit for the residents to have before bed. Interview on 08/02/23 at 10:45 A.M. with Resident #26 revealed she provided her own snacks and denied seeing the staff pass snacks to the residents between meals or at bedtime. Interview and observation with Licensed Practical Nurse (LPN) #106 of the 200 unit kitchenette on 08/02/23 at 10:50 A.M. revealed there were three small packages of graham crackers and two packages of honey gram crackers. LPN #106 confirmed the snacks available were always the same as what was observed. Interview with the Administrator on 08/02/23 at 12:30 P.M. revealed Dietary Manager #100 ensures there is a supply of snacks available on every shift for the residents. The Administrator indicated the staff does not routinely pass or offer snacks to the residents. Interview on 08/02/23 at 2:20 P.M. with Resident #28, who resided on the 200 unit, revealed he was (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: 366170 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 366170 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/03/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Sanctuary at Tuttle Crossing 4880 Tuttle Road Dublin, OH 43017 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)