Health inspection·March 20, 2025

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 **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, taste tray, food temperature, policy review, and interview, the facility failed to prepare food to enhance texture and serve at an appetizing temperature. This affected all 83 of 83 residents in the facility. The facility census was 83. Residents Affected - Many Findings include: Observation of the lunch tray line took place on 03/20/25 at 11:41 A.M. [NAME] #94 was wearing gloves and had hair and beard coverings. When asked if temperatures were obtained he stated he already took the temperatures and motioned toward a binder. Observation revealed the lids were off the chaffing dishes on the steam table. Dietary #94 plated the dining room trays. They were sent to the dining room in an open to air cart. Interview on 03/20/25 at 12:10 P.M. until 12:20 P.M. of anonymous residents dining in the dining room revealed: - The food is hot in the dining room, not for the hall trays (reported by three residents). - They repeat the same vegetables a lot (reported by four residents). - There serve carrots too often. - It is hard to cut up the food. Returning to the tray line at 12:22 P.M. revealed the [NAME] #94 had plated an insulated cart of hall trays. They were taken out of the kitchen. The chaffing dishes remained uncovered. Prior to starting the next hall [NAME] #94 was asked if food temperatures were obtained halfway through the tray line prior to the start of hall trays. [NAME] #94 stated he did not retake the temperatures of the food on the tray line. At 12:25 P.M. [NAME] #94 obtained temperatures on the tray line. The fish temperature was 128 degrees Fahrenheit. The temperature was 170 degrees at the start of the lunch trays. The taters tots registered 122 degrees Fahrenheit. They were 187 degrees at the start of the trayline. [NAME] #94 did not seem to understand the temperatures were too low to be serving from the trayline. [NAME] #94 said he did not know if all the sections of the steam table were working consistently. He indicated he thought two sections did not have enough water. [NAME] #94 continued to plate the lunch trays without heating up the fish and tater tots. Due to resident complaints of cold hall trays and the food being below 135 degrees Fahrenheit on the trayline a test tray was requested after the last meal was plated. The Surveyor and Dietary (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: 366331 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 366331 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/20/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sienna Skilled Nursing & Rehabilitation 250 Cadiz Road Wintersville, OH 43953 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)