Based on observations and review of facility policy, it was determined that the facility failed to maintain resident dignity and respect by serving meals in a timely manner to individuals seated at the same table and implementing dignified feeding practices in the main dining room. Findings include: Review of the Dining Room Service policy dated 1/1/23, revealed that Residents will be greeted and served upon arrival. Observations of the afternoon meal in the main dining room on 9/6/23, between 11:43 a.m. and 12:07 p.m. revealed the following. Observation at 11:43 a.m. on 9/6/23, revealed Resident R26 and Resident R150 were seated at the same table in the dining room together and at 11:45 a.m. Resident R26 was served his/her meal and began eating. At 11:51 a.m. Resident R26 completed his/her meal and left the dining room. Resident R150 was served his/her meal at 12:07 p.m. 22 minutes after Resident R 26 received and completed his/her meal. Observation on 9/6/23, at 11:48 a.m. revealed a table in the dining room with five residents seated together around the table. One resident was served his/her meal at 11:48 a.m. while the other four residents watched him/her eat. The last resident at the table was served at 12:06 p.m. 18 minutes after the first resident received and began eating his/her meal. During an interview on 9/6/23 at 12:52 p.m. Dietary Manager Employee E2 verified that the current process for delivering meals to residents in the dining room included that when residents arrive at the dining room, the staff take the resident's meal ticket to the kitchen and when the dietary staff get to the ticket then they prepare the meal and take it to the residents. 28 Pa. Code 201.14(a) Responsibility of licensee 28 Pa. Code 211.12(d)(1)(5) Nursing Services

Based on observations, review of facility policy, and staff interview it was determined that the facility failed to utilize proper hygiene by not wearing a hair net to prevent contamination of food during the lunch food preparation. Findings include: Review of facility policy entitled Hair Restraints dated 6/10/22, indicated that food handlers that have direct contact with food shall wear hair restraints, such as hairnets, beard nets and caps that cover exposed body hair. Observation of the lunch service on 9/06/23, at 11:15 p.m. revealed that Dietary Employee E1 was not wearing a hair net when checking the temperature of the food being served. He/She did not don (put on) a hair net until reminded to do so by the supervisor after three trays of food were already checked for temperatures. During an interview on 9/06/23, at 11:30 a.m. Dietary Manager Employee E2 confirmed that Dietary Employee E1 should have been wearing a hair net to avoid the potential of contaminating the lunch meal. 28 Pa. Code 211.6(f) Dietary Services