Health inspection·January 22, 2025

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Based on interview and record review, the facility failed to report potential allegations of theft to the local law enforcement for two (R1 and R2) of four residents reviewed for misappropriation of property in a sample of four. Findings include: The facility's Abuse, neglect and Exploitation policy, dated 7/1/24, documents Policy: 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 the resident's consent. 2. The facility will designate an Abuse Prevention Coordinator in the facility who is responsible for reporting allegations of suspected abuse, neglect, or exploitation to the state survey agency and other officials in accordance with state law. B. Possible indicators of abuse include but are not limited to: 4. Resident reports of theft of property or missing property. The facility's Grievance Logs dated November 2024 through January 2025 documents R1 and R2 made allegations of theft (missing money). 1. The facility's initial Reportable for R1, date of occurrence 1/3/25, documents Former resident (R1) contacted the facility from home and alleges that (R1) has missing money .Investigation begun, full report to follow. This report also documents Incident Category -Resident Misappropriation of Property/Theft. Police notified - no. Status of resident - discharged . The facility's undated final report for R1 summarizes that R1 had $54 and a blank check in an envelope that was locked in a medication cart's narcotic box. R1 forgot about the envelope upon discharge, called the facility from home to retrieve it and the money was not in the envelope. 2. The facility's initial Reportable for R2, date of occurrence 12/10/24, documents Incident Description (R2) notified (V1) that (R2) had $27 missing from her change purse. Incident Category - Resident Misappropriation of Property/Theft. Police Notified - no. The facility's undated final report for R2 summarizes that R2 had $27 in R2's change purse in R2's room that went missing. On 1/17/25, at 3:13pm, V1 Administrator stated that the police were not notified. (R1) was already (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: 145044 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 145044 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/22/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Allure of Peru 1301 21st Street Peru, IL 61354 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)