**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to insure the services provided or arranged by the facility, as outlined by the comprehensive care plan, met professional standards of quality for one (Resident #1) of seven Based on record review, observation, and interviews with Speech Therapist, Registered Dietician, physician, and staff, the facility failed to supervise residents with aspiration precautions during meals for 3 of 3 residents (Residents #89, #33, and #57) reviewed for aspiration precautions. Resident #89 was observed by nursing staff with a mouth full of food making a vomiting noise after meal time. She was transferred to the emergency room by Emergency Medical Services and died in the ambulance on the way to the hospital. Immediate Jeopardy began on [DATE] at approximately 1:30 PM when Nursing Assistant #1 observed Resident #89 making a vomiting sound following the lunch meal that she had eaten in the dining room. She was assessed by nursing staff to have a large amount of ground/chewed food, estimated at 4 ounces, in her mouth. Emergency Medical Services (EMS) were contacted by facility staff to evaluate Resident #89 for the chief complaint of choking. Resident #89 was en route to the hospital with EMS when she went into [MEDICAL CONDITION] and [MEDICAL CONDITION] and was pronounced dead on [DATE] at 2:29 PM.