Inspection·February 27, 2026

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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to ensure residents were free from physical and verbal abuse. This applies to 3 of 3 residents (R1-R3) reviewed for abuse in the sample of 11.The findings include: 1. The Final Abuse Report dated 2/11/26 shows R1 is [AGE] year-old male with diagnoses including dementia, anxiety and chronic pain. R1 has moderate cognitive impairment. R2 is a [AGE] year-old male with diagnoses including dementia, COPD, and hypertension. R2 is cognitively intact. On 2/6/26, V13 (RN) heard shouting between residents when he entered the room (R1, R2) were on the floor side by side. (R2's) arm was loosely wrapped around (R1's) neck holding him to the ground and (R1) was attempting to get loose. On 2/27/26 at 10:18 AM, R2 was in his room lying in bed, he said there was something that happened between him and another resident (R1). R2 said he put R1 in a choke hold, it was a big mistake. R2 said R1 was at the wrong place at the wrong time and the staff took care of it. On 2/27/26 at 10:27 AM, R1 was in the activity room interacting with other residents. R1 was alert to self, and he was not able to answer questions. R1's speech was incoherent and gibberish. On 2/27/26 at 1:40 PM, V13 (RN) said on 2/6/26, he was in the nurses office and could hear shouting. He entered R2's room and saw R2 and R1 on the floor. R2 had his arm wrapped around R1's neck loosely like they were wrestling. R1 was yelling to get R2 off him. V13 said he separated the residents and assessed both residents. V13 said R2 did not sustain any injury or bruise to his neck and R1 had wandered into R2's room. On 2/27/26 at 12:38 PM, V1 (Administrator) said R1 and R2 shared a bathroom. R2 was new to the facility. During the night R1 went to the bathroom and exited the bathroom into R2's room. That startled R2, he reacted and placed hands on R1. V1 said she did substantiate the physical altercation. V23's (CNA) statement dated 2/9/26 shows he heard (R1) yelling profanity from another resident's room. He went into R2's room and found both residents on the floor. (R2) had (R1) in a choke hold and (R1) was pulling (R2's) hair, he yelled for V13. 2. The facility's Final Abuse report dated 2/11/26 shows allegation of verbal altercation between a resident and staff. (R3) is a [AGE] year old male with diagnoses including edema, type 2 diabetes, antisocial personality disorder, bipolar, and major depression. (R3) is cognitively intact. On 2/5/26, (R3) admitted he called a dietary staff member racial slurs.V12 (Dietary Staff/Former Employee) said he was verbally protecting himself against the racial slurs. Staff members interviewed said (R3) was screaming racial slurs at (V12). (V12) began shouting back at (R3) then moved toward him indicating that he would strike. Staff member stepped in between (R3) and (V12) and both were separated.Evidence noted (V12's) response to (R3) was inappropriate and was terminated. On 2/27/26 at 10:45 AM, R3 was in his room lying in bed. He said he got into it with the cook (V12). R3 said V12 came at me like he was going to hit me. R3 said V12 came out of the kitchen and asked what my problem was and told me I could not talk to him like that (calling him racial slurs). R3 said the facility got rid of V12 after the incident. On 2/2726 at 12:41 PM, V4 (ADON) said on 2/6/26, staff notified her of the (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: 145418 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 145418 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/27/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avenues at Royal Oak 605 East Church Street Kewanee, IL 61443 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)