Inspection·December 12, 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 observation, interview, and record review, the facility failed to follow their abuse policy by not protecting a resident from employee-to-resident abuse. This failure resulted in R85 sustaining redness, mild swelling, and facial bruising. This affected 1 resident of 3 reviewed for (Employee-to-Resident) Abuse in a total sample of 29.Findings include:On 12-9-25 at 8:26 AM R85 was observed with a resolving facial bruise below his right eye. R85 said 2 weeks ago, V16 (unnamed Agency Certified Nurse Aide) punched R85 in the face. R85 said the V16 did not knock on the door and announce she is coming in the room. R85 said he does not remember V16's name nor did she announce herself. V16 told R85 she did not read the door signs or use the doorbell because R85's front door is too cluttered. R85 said V16 was tending to R85's roommate. R85 said he spilled his coffee and V16 was coming at R85 in an aggressive manner. R85 said he threw his coffee at V16. R85 said V16 punched R85 in the face with her left hand. R85 said he had blood from his face and refused to let the nurses tend to him. R85 said his facial bruise is resolving. R85 said he had some defensive scratches on his arm which have healed.On 12-9-25 at 12:01 PM, V15 (Registered Nurse) said R85 is alert, oriented, and able to make simple needs known. V15 said she heard agency V16 shouting for help in front of R85's door. V15 said she came running with Nursing Supervisor. V15 said she saw V16 with coffee stain on V16's upper trunk. V16 told V15 R85 poured his coffee on V16. V15 went inside room and asked R85 what happened. V15 said R85 was shouting and refused body assessment. V15 said she saw (new) redness on the bridge of R85's nose and (new) redness to R85's lateral eye. V15 said she did not see any blood at this time. V15 said this redness was not seen during V15's prior shift.On 12-11-25 at 11:11 AM, V2 (Director of Nursing) said V16 was providing care to the R85's roommate and was upset at V16 thus R85 threw his coffee at V16. V2 said V16 asked for help from V15 (Registered Nurse). V2 said V15 went to room. V2 said V16 had a coffee stain on her side. V2 said R85 sustained redness to right lower eye. V2 said V15 attempted to assess R85 however R85 refused.BIMS Score (ARD 10-23-25) documents: 15.Nursing Progress note dated 11-25-25 documents: Situation: 1. The change in condition, symptoms, or signs observed and evaluated is/are: Patient observed with skin tear around his eye and face while trying to pour hot coffee to staff. MD notified. Patient refuse body assessment. Patient was sent to ER for further evaluation. Appropriate parties notified.Police Report dated 11-25-25 documents: Upon arrival, I spoke with the complainant, R85. R85 related that he became very upset when a CNA, later identified as V16, entered his bedroom (217) without knocking, retrieved his urinal jug from his bathroom, and allowed his roommate to use it. R85 stated that this upset him greatly, and he acknowledged that he became aggressive and began calling V16 names. R85 stated this escalated to him throwing his cup of coffee at V16. V16 reported that after R85 threw the coffee, V16 became upset and began throwing various items in R85's room at him and approached R85. R85 stated he went into defense mode and that during the altercation, V16 struck R85 in the face with a closed fist, knocking R85's glasses off. R85 stated the incident continued for a few minutes until (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: 145324 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 145324 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/12/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Harmony Park Ridge 1001 North Greenwood Avenue Park Ridge, IL 60068 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)