Health inspection·July 9, 2025

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to ensure a resident's haircut was done safely for 1 of 5 residents (R1) reviewed for safety in the sample of 5. The findings include: On 7/8/25 at 9:17 AM, R1 was seated in a wheelchair in his room. R1 had a full beard and partially bald head. R1 stated he received a hair and beard cut a couple of weeks ago and was all cut up during the process. R1 said a female staff member (name unknown) wheeled him into the beauty shop and just started in on me with hair clippers. R1 said the staff member took the guard piece off the clippers during the process and cut him under his chin. R1 said he hollered and yelled quit!. R1 said the staff member 'kept right on with what she was doing', and he felt like she didn't care. R1 said she moved to the back of his head with the clippers, and it was hurting him there too. On 7/8/25 at 9:39 AM, V1 (Administrator) stated R1 was given a haircut a few weeks ago by a CNA. V1 said when the facility beautician was out on medical leave, the aides cut R1's hair and beard. V1 said V9 (CNA) took it upon herself to wheel R1 into the beauty shop and use electric clippers to trim his beard and hair. V1 said V9 is not a trained beautician, and she should not have been giving haircuts to any resident. V1 said as far as he knew, none of the CNAs are licensed beauticians. On 7/8/25 at 10:09 AM, V10 (R1's daughter) stated R1 was complaining to her about a haircut he had received from a staff member (V9). V10 said the facility knows she does not want V9 caring for R1. V10 said she feels like V9 rushes R1 during cares and does not like him. V10 said R1 is very sensitive to who can cut his hair. V10 said several other aides told her R1 was cut up during the haircut by V9. V10 said only beauticians are allowed to cut his hair, but it was so bad this time another aide (V4) had to go back over it and fix it. V10 said she is okay with the aides cutting R1's hair if it is not V9. On 7/8/25 at 10:50 AM, V4 (CNA) stated she heard R1 yelling stop it from the beauty shop a few weeks ago. V4 said she did not go and see what was happening but could tell that R1 was upset and agitated. V4 said she spoke with R1 about 30 minutes later and was told V9 just cut his hair and beard. V4 said it was horrible and uneven. R1 had a large red area on the back of his neck that looked like razor rash. The skin was all red and patchy behind his ear and under his neck. R1 had razor nicks under his neck. V4 said the family has allowed her to cut R1's hair in the past so she did her best to recut his hair that same day. On 7/8/25 at 10:24 AM, V3 (CNA) said V9 was accused of cutting R1 during a haircut and 'yes that is (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: 145319 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 145319 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/09/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Arc at El Paso 555 East Clay El Paso, IL 61738 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)