Health inspection·May 16, 2025

F 0602 Protect each resident from the wrongful use of the resident's belongings or money. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review the facility failed to prevent the theft of controlled medications for one resident (R2) of three residents reviewed for misappropriation of property in the sample of 15. Residents Affected - Few Findings include: Facility Policy/Abuse, Neglect and Exploitation dated 2025 documents: It is the policy of this facility to provide protections for the health, welfare and rights of each resident by developing and implementing written policies and procedures that prohibit and prevent abuse, neglect, exploitation and misappropriation of resident property. Misappropriation of Resident Property means the deliberate misplacement, exploitation, or wrongful, temporary or permanent, use of a resident's belongings or money without resident consent. Facility Policy/Controlled Substance Administration and Accountability dated 2025 documents: It is the policy of this facility to promote safe, high quality patient care, compliant with state and federal regulations regarding monitoring the use of controlled substances. The facility shall have safeguards in place in order to prevent loss, diversion, or accidental exposure. Physician Orders indicate R2 had an order dated 1/4/25 for Hydrocodone-Acetaminophen (opioid) 10-325mg (milligrams) Give 1 tablet by mouth every 6 hours as needed for Pain. On 4/28/25 at 11am the above order was changed to Hydrocodone-Acetaminophen Oral Tablet 10-325mg. Give 1 tablet by mouth every 6 hours as needed for Pain to include Do Not exceed 4000mg acetaminophen from all sources per day. Final Investigation Report dated 5/5/25 indicates the allegation of R2's missing narcotics (Hydrocodone) was substantiated. Investigation indicates local Police were notified of R2's missing medications and report filed. All medication carts were searched, and missing narcotics were not found; all other controlled medication counts were correct. Investigation indicates on 4/25/25 V17, RN (Registered Nurse) approached V8, LPN (Licensed Practical Nurse) who was working on the same hall but a different cart and asked V8 for excess medications from her narcotic box on V8's cart to go waste the medications with V2, DON (Director of Nursing). During an investigation interview V17 acknowledged asking V8 for R2's medications from the narcotic box and states she took the medications to V2, DON. Investigation interview with V2 indicates V2 acknowledged that V17 only brought her two bottles of liquid (controlled) medications that belonged to R6 and nothing else. Investigation indicates based on video footage, V17 was seen entering V2's office with a few bottles of medications and an indeterminate number of pill cards and when V17 leaves a few minutes later, V17 is still carrying the pill cards. During the investigation, V17 was asked what she did with the medications/cards and responded (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: 145027 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 145027 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Allure of the Quad Cities 833 Sixteenth Avenue Moline, IL 61265 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)