Inspection·June 16, 2025

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Based on interview and record review the facility failed to follow their abuse policy procedures and prevent a resident-to-resident physical abuse. This affected two of five residents (R3, R4) reviewed for abuse. This failure resulted in R4 slapping R3 in the face after R3 backed into R4 with a wheelchair. Findings include: 1.)R4's diagnoses include schizoaffective disorder bipolar type. R4's (3/28/25) BIMS (Brief Interview Mental Status) determined a score of 15 (cognition intact). R4's (10/21/24) care plan states resident has the potential to be physically/verbally aggressive related to poor impulse control, interventions: when the resident becomes agitated: intervene before agitation escalates, guide away from source of distress, engage calmly in conversation. 2.) R3's diagnoses include schizophrenia. R3's (10/2/24) care plan includes risk for abuse, interventions: observe resident when in company of peers. R3's (6/3/25) BIMS determined a score of 15. The 5/2/25 initial facility reported incident states R3 was scratched by R4. Facility staff were present and intervened immediately. R3 was evaluated by Nursing staff and had minimal scratches on her right cheek with no other injuries. R3 rated her pain at a one. R4 was placed on 1:1 monitoring and petitioned out for a psychiatric evaluation. The 5/25/25 final facility reported incident affirms R3 was provided first aid for minor scratches to right cheek. On 6/10/25 at 4:12pm, surveyor inquired about the 5/2/25 incident. R3 stated (R4) was backing her wheelchair up and ran into my wheel. I said wait a minute and she (R4) hauled off and hit me in my face. I told her you ain't gonna get away with this and punched her in the face. She hit me again and I punched her in the eye as hard as I could. She grabbed a hold of my face, scratched me under my eye and on my nose. On 6/10/25 at 4:22pm, surveyor inquired about the 5/2/25 incident with R3. R4 proceeded to write (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: 145197 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 145197 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Aperion Care Oak Lawn 9401 South Ridgeland Avenue Oak Lawn, IL 60453 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)