Health inspection·June 11, 2025

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to adequately transcribe hospital nutrition support orders for one resident (R1) who readmitted to the facility on [DATE] and failed to follow physician orders for three residents (R2, R3, and R4) who require nutrition support. This failure resulted in R3 having a severe weight loss of 11.7% in six months and R1 who was severely underweight with multiple pressure ulcers to not receive adequate nutrition. Residents Affected - Few Findings Include: R1 is a [AGE] year-old male who originally admitted to the facility on [DATE]. R1 was hospitalized on [DATE], readmitted to the facility on [DATE], and sent to the hospital again on 6/2/2025. R1 remains in the hospital at the time of this survey. R1 has multiple diagnoses including but not limited to the following: Respiratory failure, protein calorie malnutrition, intracranial injury, hydrocephalus, traumatic brain injury, seizures, dysphagia, tracheostomy, gastrostomy, oxygen dependence, AFib, and dependence on oxygen. Hospital discharge records dated 5/26/2025 show tube feeding diet of TwoCal (2.0) at 35 mililiters per hour to be ran continuously. Also shows resident was to receive the following nutritional supplements: Prosource one time a day and Juven two times a day. R1's physician orders dated 5/26/2025 state in part but not limited to the following: TwoCal at 35 mililiters/hour to be started at 11AM and off at 6AM. It is to be noted that the the nutritional supplements of Juven was not started until 5/29/2025 and Promote was not started until 5/30/2025. It is to be noted that R1's body weight measurements were as follows: 88.8 lbs (Admission-3/17/2025); 77.0 lbs (Readmission-5/29/2025); and 74.4 lbs (6/2/2025) R1 experienced a weight loss of 3.4% in four days, is considered to be severely underweight, and had multiple pressure ulcers. R2 is a [AGE] year-old male who originally admitted to the facility on [DATE] and continues to reside in the facility. R2 has multiple diagnoses including but not limited to the following: respiratory failure, emphysema, alcoholic liver disease, COPD, tracheostomy, gastrostomy, anxiety, epilepsy, dysphagia, schizophrenia, and dependence on respirator. On 6/10/2025 at 10:50AM, R2 was observed laying in bed with no tube feeding running. R2's physician orders state in part but not limited to the following: Jevity 1.5 at 70 mililiters/hour x 22 hours (On at 10AM and off at 8AM). (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: 145419 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 145419 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/11/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Bria of Elmwood Park 7733 West Grand Avenue Elmwood Park, IL 60707 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)