Inspection·August 19, 2025

F 0585 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. Based on observation, interview, and record review the facility failed to educate residents on what a grievance is, provide grievance forms, and provide a clear and noticeable destination for grievances to be submitted. This failure has the potential to affect all 63 residents who reside in the facility. Findings Include:The Filing Grievances/Complaints policy dated 12/2004 documents Our facility will assist residents, their representatives (sponsors), other interested family members, or resident advocates in filing grievances or complaints when such requests are made. The Ombudsman Program Residents' Rights Booklet (undated) documents Your personal property rights. You have the right to keep and wear your own clothing. Your facility must try to keep your property from being lost or stolen. If your property is missing, the facility must try to find it.The Resident Council meeting minutes dated 7/8/2025 documents, R11, R28, R38, R48, and R64 all confirmed they did not know what a grievance was or how to file a grievance.The facility census sheet dated 8/18/2025 documents 63 residents reside in the facility.On 8/18/2025 at 1:13PM, R8 voiced she has had a brown jacket missing since Christmas and has never gotten it back. R8 voiced she did not know what a grievance was or how to file one.On 8/18/2025 at 1:20PM, R3 stated she has a turquoise dress missing for months and that laundry keeps saying they are looking for it. R3 voiced she did not know what a grievance was.On 8/18/2025 at 1:30 PM, R4 voiced she had pink pants missing and she does not know what a grievance is. R4 stated she has had a lot of clothing items come up missing and that this happens all the time.On 8/18/2025 at 3:05PM, V4 (Laundry Aide) stated residents tell me things are missing all the time V4 stated she will try and go to the laundry room and look for the article of clothing that is missing and if she cannot find it, she will tell V5 (Housekeeping/Laundry Supervisor). V4 does not know about grievances or how to tell residents to file one.On 8/19/2025 at 8:30AM, V5 (Housekeeping/Laundry Supervisor) stated when a resident does voice that they cannot find an article of clothing she will checks the lost and found, check resident closets, and throw the word out there and keep looking V5 stated there is a list in the laundry office of resident missing clothing items for other laundry staff to keep an eye out for but does not advice residents to file a grievance.On 8/19/2025 at 12:05PM, The laundry room had four carts for each hall, room numbers in sections of what rooms each cart had, and clothes had labels of each resident's piece of clothing. The bulletin board hung that above the folding table by the dryer on the wall had no list of missing clothing items. On 8/19/2025 at 12:05 PM, V11 (Laundry Aide) stated when residents complain of missing clothing items, she will search the lost and found cart. If she cannot locate it on the lost and found cart, V11 stated she will then search in the residents closet and if the item is not found V11 will put a note on the bulletin board. V11 stated there is no list of residents with missing items. V11 confirmed R4's pink pants, R8's brown jacket, and R3's dress has been missing.On 8/19/2025 at 12:40PM, V12 (Social Services Director/SSD) stated she was supposed to oversee grievances when she was hired in November 2024. V1 (Administrator) did not (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 2 Event ID: 145000 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 145000 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/19/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Washington Senior Living 1201 Newcastle Washington, IL 61571 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)