Health inspection·August 23, 2024

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 ensure a resident was free from misappropriation of his property. Residents Affected - Few This applies to 1 of 3 residents (R1) reviewed for abuse/misappropriation in the sample of 6. The findings include: The facility reported incident dated 7/11/24 states, (R1) stated that he asked a staff member, (V6) to take his link card to purchase him some beverages at the store. (R1) stated that the staff member never returned his card. (V6) is no longer an employee of the facility. (R1) canceled his Link card and the money will be transferred to his new card. No observations of emotional nor mental distress noted. On 8/23/24 at 10:45 AM, R1 was ambulating in the hall towards his room. R1 agreed to speak with Surveyor in his room. R1 stated, Someone took my (Link) card- I thought I gave it to someone I could trust to get me some snacks and they never brought it back. I have a card now (Resident removed card from his pocket and showed it to Surveyor) but there is no money on it. I know the police were here and that scared me because I didn't do anything wrong. I want to get out of here but they won't give me any information and I don't have a card with any money on it. On 8/23/24 at 11:00 AM V3 (PRSD- Psychosocial Rehabilitation Director) stated, He reported to staff that he was missing his Link card- I passed it on to my superiors. R1's Progress Notes dated 7/11/24 written by V3 document, Today, Resident reported that he gave his Link Card to a particular Staff member (V6) to buy him beverages at the store. Resident reports that the Staff member didn't return his card. This information was immediately reported. The (City) Police Department was called and two (2) Officers came to the facility to complete an interview with the Resident. Report # was given. PRSD (Internet searched) Link to find a number to call and report the card, as well as provide this entity with the report # and advocate on behalf of the Resident to cancel the card with hopes of Resident receiving a new card with an updated balance. Social Services contacted the (State) Link Card Services through the (State) Department of Human Services and spoke to (a) Representative and made her aware of what was verbally reported by Resident. Social Services also provided (Representative) with the Police Report # and (Representative) stated that she would promptly cancel the card that was issued to Resident. (Representative) also explained that once the Resident received his new card, the instructions on how to set up a new pin would be enclosed also. Resident expressed his thanks and call was then completed. PRSD allowed him time to process and PRSD sought the Resident out again to provide education on the importance of allowing Social Services to assist him with his food purchases, providing receipts to him, and encouraging Resident to allow (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: 145180 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 145180 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/23/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Aperion Care Chicago Heights 490 West 16th Place Chicago Heights, IL 60411 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)