Health inspection·October 4, 2023

F 0568 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. Based on interview and record review, the facility failed to ensure residents received a quarterly statement of their monthly Social Security stipend for five of five residents (R5, R28, R44, R81, R102) reviewed for Personal Funds in the sample of 26. The findings include: On 10/02/23 at 9:39 AM, R44 said, The person on the first floor that handles the resident's money never answers the phone. The first person would come around and ask if I needed any money, the new lady is hard to get to. If I wanted to get a couple of dollars I would have to wait for my son. On 10/03/23 at 2:17 PM, V14, Business Office Manager, said, I do not send out quarterly statements to the residents. I give the resident their balance when they make a withdrawl. Residents are the only ones that have access to their accounts. On 10/04/23 at 9:05AM, R81 said, I do not get quarterly statements. On 10/04/23 at 9:12 AM, R102 said, I think it started in November 2022. I have asked twice for a statement regarding the balance of my funds; no one has given me one. I have no idea how much money I have in my account. I have no idea how to get my money. I asked about it, I was told they would look into it; I have not heard back. I have been asking for a couple of months now to get ahold of the finance department, no one has contacted me. I do not want to get anyone in trouble, but I have questions and want answers. On 10/04/23 at 9:26 AM, R5 said, If the facility sent me a quarterly statement, I would know the balance in my account. I like to buy my own toothpaste. On 10/04/23 at 9:30 AM, R28 said, I would like to know my balance. It would be nice to give my friend some money to go out and buy a few items for me. On 10/04/23 at 10:00 AM, R44 said, I am not always able to go down to the bank or (V14's) office. It is difficult for me to get out of bed. I do not get quarterly statements telling me what my balance is. The facility's Resident Fund Trial Balance, dated 10/03/23 at 3:28PM, shows multiple residents including R5, R28, R44, R81, and R102. On 10/04/23 the facility did not provide a policy for Resident Personal Funds. Page 1 of 4 145403 145403 10/04/2023 Alden Poplar Creek Rehab & Hcc 1545 Barrington Road Hoffman Estates, IL 60169

F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to provide ADL (Activities of Daily Living) assistance for residents that are totally dependent on staff for toileting/incontinence care for 2 of 26 residents (R103, R82) reviewed for ADLs in the sample of 26. Residents Affected - Few The findings include: 1. R82's resident assessment, dated 7/19/23, showed R82 was totally dependent on staff for toileting/incontinence care. The assessment showed R82 was always incontinent of urine and stool. On 10/2/23 at 10:38 AM, R82 was seated in her wheelchair in the second-floor dining room. R82 stated staff last provided her with incontinence care at 9:00 AM. On 10/2/23 at 11:01 AM, R82 remained seated in her wheelchair in the second-floor dining room. On 10/2/23 at 11:35 AM, R82 remained seated in her wheelchair in the therapy room. On 10/2/23 at 12:09 PM, R82 returned to the second floor, from therapy. R82 remained in her wheelchair. On 10/2/23 at 1:20 PM, V7, Certified Nursing Assistant (CNA), and V8, CNA, transferred R82 from her wheelchair to her bed. V7 and V8, CNAs, removed R82's incontinence brief. Inside of R82's incontinence brief was an additional smaller, rectangular incontinence pad. The pad was saturated with urine. R82's incontinence brief was also soiled with a small amount of urine. R82's vaginal area and groin were bright red. When R82 was asked about wearing two incontinence pads/briefs, R82 stated, I want to wear two because I don't want to leak onto my pants. V7, CNA, stated she last provided incontinence care to R82 at 9:00 AM that morning. 2. R103's resident assessment, dated 9/25/23, showed R103 was totally dependent on staff for toileting/incontinence care. The assessment showed R103 was always incontinent of urine and stool. On 10/2/23 at 9:45 AM, R103 was in bed, eating breakfast. R103 stated she was last provided incontinence care around 8:30 AM, that morning. On 10/2/23 at 11:45 AM, V6, CNA, and V9, CNA, entered R103's room to provided cares. V6 and R9 removed R103's incontinence brief. R103's was soiled with a large amount of urine. Open, reddened, excoriated areas were noted to R103's left and right buttock. R103's vaginal area was red. On 10/3/23 at 10:53 AM, V10, Wound Nurse, stated R103 had MASD (moisture associated skin damage) to her buttocks due to her skin being exposed to urine for long periods of time. V10 stated, (R103) should be checked for incontinence every 2 hours. Her skin needs to be kept dry so it can heal. On 10/3/23 at 8:55 AM, V5, Assistant Director of Nursing (ADON), stated staff should toilet or provide incontinence care to residents every two hours. On 10/3/23 at 10:44 AM, V2, Director of Nursing, stated staff should toilet or provide incontinence care to residents every two hours. 145403 Page 2 of 4 145403 10/04/2023 Alden Poplar Creek Rehab & Hcc 1545 Barrington Road Hoffman Estates, IL 60169

F 0677 On 10/4/23 at 11:10 AM, V5, ADON, stated the facility did not have a policy on incontinence care. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 145403 Page 3 of 4 145403 10/04/2023 Alden Poplar Creek Rehab & Hcc 1545 Barrington Road Hoffman Estates, IL 60169

F 0686 Provide appropriate pressure ulcer care and prevent new ulcers from developing. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to implement R13's Care Plan interventions to reduce pressure on her stage 3 pressure ulcer for 1 of 4 residents (R13) reviewed for Pressure ulcers in the sample of 26. Residents Affected - Few The findings include: R13's current Physicians Orders on 10/03/23 shows low air loss mattress ordered 08/29/23. R13's Care Plan on 10/03/23 shows, Actual alteration in skin integrity: Pressure Ulcer to sacrum. Intervention-Low Air loss Mattress initiated 08/24/23. On 10/03/23 at 9:49AM, R13 was in bed laying on her back. R13 was not on a low loss air mattress. On 10/03/23 at 10:15AM, V10, Wound Care Nurse, said, (R13) was admitted with a Stage three pressure ulcer. The low air loss mattress shoots air into the mattress alternatively so pressure is not on the wound continuously. (R13) just had a room change, and the staff may have left her mattress behind in her old room. The facility's Prevention and Treatment of Pressure Injury and Other Skin Alterations policy, dated 03/02/21, shows, Implement preventative measures and appropriate treatment modalities for pressure injuries and/or other skin alterations through individualized resident care plan. 145403 Page 4 of 4