Health inspection·December 27, 2024

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to provide information to install cameras in a resident's room. This applies to 1 of 1 resident (R2) reviewed for resident rights in a sample of 10. The findings include: The EMR (Electronic Medical Record) shows R2 was admitted to the facility with diagnoses including hemiplegia and hemiparesis of the left non-dominant side, type 2 diabetes mellitus, delusional disorders, bipolar disorders, dementia, epilepsy, low back pain, and gastroesophageal reflux disease. R2's MDS (Minimum Data Set), dated October 18, 2024, showed she was moderately impaired. R2 required moderate assistance with eating, oral hygiene, substantial assistance for upper body dressing, and personal hygiene, and was dependent on staff for shower/bathing, toileting hygiene, lower body dressing, putting on/taking off footwear. R2's progress notes, dated December 13, 2024 at 1:27 PM, showed the following, Care conference was held for (R2) on the 5th of December with family, and IDT (Interdisciplinary Team), in attendance, which included Social services, Activities, Dietary, Nurse practitioner and Ombudsmen. Residents medical progress and goals were discussed. Resident is long term care and a full code. Family would like for her to receive 1:1 activities in her room and pertaining to dietary with no added salt, nutrition shakes and fresh fruit request. Family would like Nursing to get her up more, and possibly have a camera installed in her room. Staff will follow up w/request and grievance policy was discussed. Social Services remain available and will continue to monitor progress of residents care and family request. On December 19, 2024 at 8:09 AM, V31 (Family Member) said two weeks earlier, the facility was supposed to give V31 information about installing a camera in R2's room. V31 said she contacted V6 (Director of Social Services) on December 11, 2024, and emailed V6 to request to receive the information to install the camera. At 1 PM, R2's room did not have a camera installed and there were no signs posted about her having a camera in the room. On December 19, 2024 at 3:29 PM, V5 (Social Services) said there were no residents in the facility who had cameras in their rooms. V5 said R2's family had mentioned wanting a camera during the care conference. V5 said she was not at the meeting, but wrote the note. V5 said she was not sure what happened with the request, so was not sure if it was a yes or no. (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 6 Event ID: 145372 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 145372 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/27/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Pearl of Joliet, The 306 North Larkin Avenue Joliet, IL 60435 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)