Inspection·February 14, 2025

F 0660 Plan the resident's discharge to meet the resident's goals and needs. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to identify and develop a discharge plan for resident (R1) with a discharge goal to return to the community. Residents Affected - Few This applies to 1 out of 3 residents (R1) reviewed for discharge services. R1's Medical Record showed R1 was admitted to the facility on [DATE] with multiple diagnoses including chronic obstructive pulmonary disease, asthma, congestive heart failure, generalized muscle weakness, and syncope. On 2/07/2025 at 11:40 AM, R1 was sitting in her wheelchair receiving 2 L (liters) of continuous oxygen via a nasal cannula. R1 stated she was frustrated because there had been delays with her discharge the prior week and now her discharge date was changed to 2/11/2025. On 2/07/2025 at 3:30 PM, V10 (R1's daughter) was interviewed via telephone. V10 stated she contacted the facility on 1/27/2025 to initiate a discussion regarding R1's discharge planning to return to her supportive living facility in the community. V10 stated during the meeting it was identified R1 required DME (Durable Medical Equipment) for her new oxygen and nebulizer therapies. V10 stated R1's original discharge date was scheduled for 2/04/2025 but then was cancelled when it was identified R1 needed additional training on how to use her wheelchair with her oxygen safely. On 2/13/2025 at 9:00 AM, V11 (R1's Supportive Living Facility Director of Nursing/DON) stated she had made multiple attempts prior to contact the facility to ensure R1 was ready for a safe return but was unsuccessful. V11 stated V10 then contacted her to inform her of R1's scheduled return date of 2/04/2025. V11 stated she was concerned because on 1/30/2025 she identified the facility had not made proper arrangements for home health services and DME ordering. V11 stated the facility thought R1's family would be obtaining R1's respiratory DME on their own, which was incorrect. V11 continued to say she then became more concerned when informed R1 now required the use of a wheelchair. V11 stated the facility was unable to show her documentation that R1 was trained on the use of her new wheelchair and oxygen equipment. V11 stated she informed V10 and V4 (Social Services) that R1 was not ready to safely return to her supportive living facility. V11 stated R1's delayed discharge could have been avoided if her goals had been identified and addressed appropriately by the facility at the time of admission and during her discharge planning. On 2 /11/2025 at 11:10 AM, V4 (Social Service) stated she was contacted by R1's family to discuss R1's discharge planning on 1/27/2025. V4 stated R1's original discharge date was scheduled for 2/04/2025. V4 stated R1's discharge date was then changed to 2/11/2025 after V11 assessed R1 at the facility. V4 stated discharge planning should be initiated by the facility's staff within 24-48 hours of a (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 3 Event ID: 145029 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 145029 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/14/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avantara Joliet 210 North Springfield Avenue Joliet, IL 60435 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)