Inspection·June 18, 2025

F 0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Level of Harm - Actual harm Residents Affected - Few **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record review, the facility failed to ensure that three residents (R2, R4 and R6) were free from physical abuse. This failure resulted in R2, R4 and R6 being attacked by their roommates. R4 stated she does not feel safe. R6 stated R6 was upset and felt helpless. Findings include: 1.) R4 is [AGE] year-old with diagnosis including but not limited to: paraplegia, major depressive disorder, polyneuropathy, cerebral infarction and obesity. R4 has a BIMS (Brief Interview of Mental Status) score of 15, which indicates cognitively intact. R5 is [AGE] year-old with diagnosis including but not limited to, other specified disorders of bone, hypokalemia, multiple myeloma and type 2 diabetes mellitus. On 6/16/2025 at 1:36 PM, R4 stated R5 came at me with scissors while I was in bed. I pulled the call light for help, and R5 snatched the call light from me and begin to hit me with it. V9 (Restorative Aide) came in and took the scissors from her. R5 then pulled out a bigger pair of scissors once V9 left the room. I (R4) called for help again and the scissors were taken from her. She was moved to a different room, but I do not feel safe here. On 6/16/2025 at 1:44 PM, V9 (Restorative Aide) stated that she went into R5's room after she (R5) called for help and at that time, R4 had a pair of scissors in which she threw on the bed. V9 also said that she took R5's scissors to prevent R5 from stabbing R4 with the scissors, but found out later that the nurse had recovered a second pair of scissors. On 6/16/2025 at 1:53 PM, R5 stated that she did not want to talk about the incident that occurred between her and R4. On 6/17/2025 at 3:30 PM, V2 (Director of Nursing/DON) stated that she was made aware that R5 had allegedly attacked R4 with a call light and that two pair of scissors were taken from R5. R4's Care plan documents the following, R4 has a diagnosis of paraplegia; R4 is at risk for abuse and neglect related to paraplegia. Facility State Report of Abuse Allegation dated 6/4/2024 documents, alleged victims: R4; alleged (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 3 Event ID: 145337 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 145337 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/18/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ryze on the Avenue 3400 South Indiana Chicago, IL 60616 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)