Inspection·January 29, 2026

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few and that no one woke R1 up to offer lunch or to feed R1 lunch. On 1/26/2026 at 3:10 PM, R4 stated that R4 did visit R1 on 1/24/2026 around 2-3:00 PM. R4 stated that R4 helped R1 call V20 because the staff did not give R1 a lunch tray.Facility Daily Assignment Sheet, dated 1/24/2026 for the day shift (7:00 am to 3:00 pm) for R1's floor, documents, in part, 2 nurses working (V25 Registered Nurse/RN and V26 RN) and 7 CNAs (V5, V8, V14, V15, V21, V24, and V29). V5 is assigned as R1's primary CNA, and V8 is assigned under special assignment as R1's 1:1 feed.On 1/27/2026 at 11:31 AM, V8 (CNA) stated that V8 worked on the day shift on R1's floor on 1/24/2026. V8 stated that V8 normally has the same set of residents assigned to V8, which normally includes R1, but the resident assignments depend on how many CNAs are staffed and working. V8 stated that on 1/24/2026 day shift, the floor had more CNAs working (7), so V8 was not assigned to R1 as the primary CNA. V8 stated that R1 is alert and oriented and will tell staff what she wants. V8 stated that V8 performs all care for R1, and that R1's arms and hands are contracted. V8 stated that when it's mealtime and if R1 is asleep (which can be common), V8 will rub R1's shoulder and wake R1 up then offer R1 the meal tray. V8 stated that sometimes R1 will only want some of the food, which R1 will feed to R1. V8 stated that even when R1's family brings in outside food for R1, V8 will present the tray to R1 and show it to R1. V8 stated that on 1/24/2026, V8 did not see R1. When asked if V8 provide lunch to R1 on 1/24/26, V8 stated, No, I (V8) did not feed (R1). This surveyor showed V8 the Daily Assignment Sheet (day shift 1/24/2026) with R1 assigned to V8 as special assignment for 1:1 feeding. V8 stated, That was a mistake. V8 stated that on 1/24/2026 at the beginning of the day shift, V8 told V21 (CNA) who the CNA was who made the schedule that morning to not put R1 on V8's assigned schedule as a 1:1 feeder resident when R1 wasn't assigned to V9. V8 stated that V8 told V21, You (V21) have to tell that CNA (V5 who is assigned to R1) that (V5) has to feed (R1).On 1/27/2026 at 2:05 PM, V15 (CNA) stated that V15 worked the day shift on R1's floor on 1/24/2026, and R1 is a 1:1 feed resident. V15 stated that residents who are 1:1 feeds that eat in their rooms, the tray is prepared in the dining room, then placed on a cart, and delivered to the room, usually by the CNA who will be feeding the resident. V15 stated that for the breakfast meal on 1/24/2026, V15 could see R1's tray on cart and knew that R1 needed to be fed one to one. V15 stated that V15 told V8 who was assigned as R1's primary CNA that V15 was finished performing V15's assigned 1:1 feed resident and is available to feed R1. V15 stated that V15 brought R1's breakfast tray in the room on 1/24/2026 and performed R1's 1:1 feed. V15 stated that V15 did not feed R1 the lunch tray or bring in lunch tray to R1 on 1/24/2026.On 1/27/2026 at 2:36 PM, V14 (CNA) stated that V14 worked the day shift on R1's floor on 1/24/2026, and R1 is a 1:1 feed resident. V14 stated that V14 has never performed a 1:1 feed for R1. V14 stated that V14 did not bring R1 the lunch tray nor feed R1 lunch on 1/24/2026.On 1/28/2026 at 11:09 AM, V21 (CNA) stated that V21 worked the day shift on R1's floor on 1/24/2026, and R1 is a 1:1 feed resident. V21 stated that on 1/24/2026 at the beginning of the day shift, V21 was asked by the nurse to make the CNA assignments when all staff were huddled at the nurse's station. V21 stated that V21 divides up the CNAs based on the number of CNAs working, and all 7 CNAs (V21 confirmed by viewing all 7 CNAs on the Daily Assignment Sheet) were informed of their resident assignments and 1:1 feeds. V21 stated that the special assignments on the Daily Nursing Assignment are the 1:1 feeds, and the 1:1 feed residents are divided up as evenly as possible with the CNAs working to distribute the workload during mealtimes. V21 stated that V8 was assigned on 1/24/2026 day shift to 1:1 feed for R1 and was responsible for feeding R1. V21 stated that V8 did not talk to V21 about changing the 1:1 feeding assignment. V21 stated that V21 did not bring R1 the lunch meal tray or feed R1 the lunch meal on 1/24/2026.On 1/28/2026 at 11:41 AM, V22 (Restorative Nursing Aide/RNA) stated that V22 worked on 1/24/2026 and was assigned to 2 floors in the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145337 If continuation sheet Page 2 of 4 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 01/29/2026 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)

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few facility, one of which was R1's floor. V22 stated that RNAs help the CNAs with 1:1 feedings if needed. V22 stated that V22 was not present on R1's floor during the lunch meal service on 1/24/2026. V22 stated that V22 did not bring R1 a lunch tray or perform 1:1 feed for R1's lunch on 1/24/2026. On 1/28/2026 at 1:51 PM, V24 (CNA) stated that V24 worked the day shift on R1's floor on 1/24/2026, and R1 is a 1:1 feed resident. V24 stated that V24 has never performed a 1:1 feed for R1. V24 stated that V24 did not bring R1 the lunch tray nor feed R1 lunch on 1/24/2026.On 1/28/2026 at 2:09 PM, V25 (RN) stated that V25 worked the day shift on R1's floor on 1/24/2026, and R1 is a 1:1 feed resident. V25 stated that V25 administered medications and fluids to R1 because R1 cannot eat or drink by R1's self. V25 stated that the assigned CNA to R1 is to feed R1 1:1 for meals and it's indicated as a special assignment on the Daily Assignment Sheet. V25 stated that V25 never has performed 1:1 feeding for R1. When asked about R1 being brought a lunch tray on 1/24/2026, V25 stated that V25 assisted with making the lunch trays, and V25 wasn't aware that R1 didn't get a lunch tray on 1/24/2026. V25 stated that V25 did not feed R1 on 1/24/2026. On 1/28/2026 at 2:25 PM, V9 (RNA) confirmed that V9 was not working in the facility on 1/24/2026, and V22 is V9's replacement when V9 is not working.On 1/28/2026 at 2:44 PM, V2 (Director of Nursing/DON) stated that R1 needs to be fed R1's meals by staff and cannot feed R1's self. V2 stated that if R1 is sleeping when the meal tray is brought into R1's room, V2 expects the staff to awaken R1 so R1 can tell the staff if R1 wants to eat now or wait to eat. V2 stated that CNAs, RNAs, and nurses can feed R1. V2 stated that the staff are to chart in the eating task with what assistance was provided during eating and expects that R1 is fed one to one. V2 stated that V2 was not working in the facility on 1/24/2026.On 1/28/2026 at 2:49 PM, V26 (RN) stated that V26 worked on 1/26/2026 for the day shift and was not assigned to R1. V26 stated that V26 had a CNA (V21) make the CNA assignments at the beginning of the 1/24/2026 at the nurse's station, and V26 reviews the assignment so V26 knows which of V26's assigned 1:1 feed residents are assigned to which CNA. V26 stated that V26 does help with 1:1 feeding of resident on V26's assignment. V26 stated that R1 is a 1:1 feed, that V26 has never performed a 1:1 feeding for R1 (not on 1/24/2026), and V26 has not brought a meal tray into R1's room.On 1/29/2026 at 2:03 PM, V29 (CNA) stated that V29 worked the day shift on R1's floor on 1/24/2026, and R1 is a 1:1 feed resident. V29 stated that V29 did not feed R1 the lunch tray or bring in lunch tray to R1 on 1/24/2026.R1's Care Plan, dated 1/29/2024, documents, in part, a focus of R1 has potential for nutritional problem related to medical diagnoses with intervention listed as to provide and serve diet as ordered.R1's Care Plan, dated 11/4/2024, documents, in part, a focus of R1 requires assist with daily care needs related to paraplegia with intervention of assist resident with ADLs.R1's ADL Task charting for Eating: Self Performance, V5 (CNA) documents, in part, on 1/24/2026 at 2:18 PM, that supervision-oversight, encouragement or cueing was performed with no check mark for resident refused.R1's ADL Task charting for Eating: Support Provided, V5 (CNA) documents, in part, on 1/24/2026 at 2:18 PM, that setup help only was provided with no check mark for one person physical assist or for resident refused.R1's Lunch Meat Ticket, dated 1/24/2026, shows that R1's diet order is low concentrated sweets, no added salt diet with thin liquids, and the 1/24/2026 lunch meal was baked turkey with gravy, half baked potato with sour cream and margarine, winter blend vegetables, [NAME] fruit crumble and diet beverage.Facility policy titled Feeding Assistance dated May 2025 documents, in part, General: To attempt to provide adequate nutrition to a resident who was unable to feed themselves by hand feeding the resident. Responsible Party: RN, LPN, Speech Therapy, Certified Nursing Assistants. Guideline: 1. Residents who are unable to feed themselves are encouraged, instructed, assisted and or fed by a qualified staff member . 3. Position resident in proper body alignment for eating. 4. Qualified staff members must be sitting not (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145337 If continuation sheet Page 3 of 4 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 01/29/2026 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)

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete standing while feeding . 8. Feed resident slowly, one bite at a time, allowing them to thoroughly chew and swallow first bite before second is given . 10. Alternate foods, allowing resident to decide if there is something they do not want. 11. If resident is not eating, offer alternatives to the meal . 17. Notify charge nurse and healthcare provider if resident is refusing meals, substitutes and/or fluids.Facility policy titled Tray Pass Policy dated May 2025 documents, in part, Policy: It is the policy of this facility to serve meals that meet the nutritional needs of the residents. Policy Explanation and Compliance Guidelines: Diets should be served in accordance with the physician's order.Job description titled Registered Nurse (undated) documents, in part, Basic Function: Under the direction of the physician, (RN) is responsible for total nursing care to all residents on the assigned unit during the assigned shift including responsibility for delegation of duties, resident nursing care, staff performance and adherence by staff members to facility policies and procedures. Essential Duties: 1. Participate in the development and implementation of an individualized patient care plan for the resident with allied health team members. 2. Implement total nursing care through assessment, planning and evaluation . 4. Assist in maintaining a physical, social and psychological environment, which is conducive to the overall welfare of the resident . 7. Assign nursing care duties to team members and ensure such duties are completed in an appropriate manner . 10. Document nursing care rendered, resident response, and all other pertinent and necessary data as outlined in the facility's policies and procedures . 12. Adhere to all facility and department safety policies and procedures.Facility job description titled Certified Nurses Aide (undated) documents, in part, Basic Function: To provide assigned residents with routine daily nursing care in accordance with established nursing care procedures, state and federal guidelines, and as directed by your supervisor. Essential Duties: . 20. Prepare resident for meals, assist serving food trays or feed as necessary and record/or report residents intake or acceptance of food . 25. Follow established safety precautions in performance of all duties . 29. Review care plans daily to ensure provision of appropriate care . 31. Treat all residents, families and visitors with kindness, dignity and respect. 32. Perform all assigned tasks in accordance with policy and procedure and instruction of your supervisor. 33. Create and maintain an atmosphere of warmth, personal interest, and positive regard as well as a calm environment throughout the unit and shift. 34. Adhere to all facility and department policies and procedures. Event ID: Facility ID: 145337 If continuation sheet Page 4 of 4