Inspection·July 3, 2025

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Based on observation, interview, and record review the facility failed to provide a home like environment by not implementing an effective remedy to fix a leaking toilet, that caused water damage to the wall in the residents' room. This affects 4 of 4 (R3, R4, R9, R6) residents reviewed for sanitary home like environment.Findings include:On 7/1/25 at 8:00am V1 (Certified Nursing Assistant/CNA) said the toilet in R3 and R4's room is leaking. V1 said the bathroom is a shared bathroom between two resident rooms. V1 said she observed this on her second day working at the facility on 6/10/25.Review of the facility census and touring the facility demonstrated R3, R4, R6, and R9 share the bathroom.On 7/1/25 at 10:01am during a tour with V4 (Maintenance Director) there was a white sheet on the floor. V4 removed the sheet, flushed the toilet, the toilet is observed leaking at the base. V4 said the wall that extends into R3 and R4's room is damaged from the water leaking. V4 said he repaired that toilet in April 2025. V4 agreed that the repair was not effective because the toilet continued to leak. V4 said the leak and the wall must be repaired. On 7/2/25 at 11:30am the shared bathroom for R3, R4, R6, and R9 was observed with a puddle of water on the floor. V4 said he fixed the issue yesterday (7/1/25). The facility's Maintenance Policy, no date noted denotes in-part plumbing fixtures and pipes shall function properly and maintained in good repair. The resident rights for people living in the nursing home denotes your facility must be safe, clean, comfortable and homelike. 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 07/03/2025 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)