Health inspection·June 4, 2025

F 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some missing $200 in cash post incident. Staff schedule reviewed and CNA [V8] placed on suspension pending investigation .After full investigation it was determined that [R1] does keep her own personal money in her room at the bedside. Resident had a total of $240 wrapped in two money wraps with equal amounts in each wrap. The resident states that $30 was left in singles, however she states she originally only had big bills. The total amount determined to be missing is $210 [V8] fits the description provided by the resident and was assigned to [R1] for the shift in question [V8] has been terminated 2. The facility's Undated Final Incident Report related to allegation of missing money from [R4] shows, [R4] made an allegation of missing money from her room Upon investigation, [R4]'s daughter .reported to the Social Services Director that resident was missing $46 from her purse on Tuesday April 1. There were two enveloped, each with $23 inside for [R4] to get her hair done and pay the beautician. Per [R4]'s Daughter the money was in her room on March 19, 2025 and was noticed missing on March 29, 2025 when [R4] went to get her hair done .On Friday April 4, [R4]'s daughter reported to Social Service Director that [R4] had 4 envelopes of money totaling $86 in a zipper pocket of her purse that was located in her rollator and they were missing On 6/4/25 at 12:08 PM, V2 (Assistant Director of Nursing) said that R4's daughter brings in money for her and puts it in envelopes. V2 said that when R4 went to pay for her hair appointment, she noticed the money was missing. R4's daughter did not report the incident at that time and brought in more money in envelopes. V2 said that after the money came up missing for the second time, R4's daughter reported it to the previous Social Service Director. 3. On 6/4/25 at 12:00 PM, R2 said that she did have money come up missing out of her bedside dresser drawer that her friend had brought her but had never seen anyone going through her personal belonging or taking her money. The facility's undated Final Incident Report shows, [R2] reported during the resident interview process on April 9 that last week she had $35 come up missing that her POA (Power of Attorney) had brought her to buy pop and snacks with [R2]'s POA .reported that she had left $35 for [R2] in her bedside nightstand. On 6/4/25 at 12:43 PM, V4 (Social Service Director) said that she was conducting resident interviews for different theft investigation when R2 told her that she was missing $35. V4 said that her personal belongings were searched for the money, but nothing was found. V4 said that she contacted R2's POA and the POA verified that she did bring R2 $35. 4. On 6/4/25 at 12:35 PM, R3 said that he had $40 missing from his pouch that he carries around. R3 said that he had never seen anyone going through his personal belonging or taking his money and he keeps his pouch with him at all times. R3 said that he puts the pouch on his wheelchair next to his bed when he sleeps at night. The facility's undated Final Incident Report shows, On Thursday, April 10, [R3] came to the Life Enrichment office and reported to [V4], that he had money missing totaling around $40 When asked on April 9, [R3] reported no missing items or money. Staff were interviewed and confirmed that [R3] had money in his pouch on April 9 but were unaware of the amount [R3]'s room was searched, and no money was found. On 6/4/25 at 12:43 PM, V4 said that R3 is alert and oriented, and he keeps his money and important (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145443 If continuation sheet Page 2 of 7 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 145443 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Allure of Zion 3615 16th Street Zion, IL 60099 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 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some things in a pouch. V4 said that R3 came to her and said that he went to use his money at the vending machine and noticed that it was missing. V4 said that she does remember that he had money prior to that because she routinely takes him to the vending machine. On 6/4/25 at 12:43 PM, V2 (Director of Nursing) said that misappropriation of a resident's money is abuse and abuse should not happen at the facility. The facility's undated Abuse, Neglect and Exploitation Policy shows, It is the policy of this facility to provide protections for the health, welfare and rights of each resident by developing and implementing written policies and procedures that prohibit and prevent abuse, neglect, exploitation and misappropriation of resident property. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145443 If continuation sheet Page 3 of 7 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 145443 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Allure of Zion 3615 16th Street Zion, IL 60099 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 0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. Level of Harm - Minimal harm or potential for actual harm Based on interview and record review the facility failed to implement their Abuse Policy regarding reporting and investigating an alleged misappropriation of money for 1 of 4 residents (R4) reviewed for misappropriation of property in the sample of 4. Residents Affected - Few The findings include: A Quality Improvement Form dated 4/1/25 shows that R4's daughter reported to V9 (Previous Social Service Director) that she left two envelopes containing $23 for her to pay to get her hair done. The envelopes were in the room on 3/19/25 and noticed both missing on 3/22/25. The form shows that the administrator was notified. A Quality Improvement Form dated 4/4/25 shows that R4's daughter reported that the resident was missing 4 envelopes of money totaling $86 that were in a zipper pocket of her purse that was located in her rollator walker. The form shows that the administrator was notified. An untitled document dated 4/7/25 to Illinois Department of Public Health (IDPH) shows that R4 reported that she has had money missing, an investigation has been initiated and a five-day final is to follow. The undated Final Investigation related to allegation of missing money from R4 shows, Upon investigation, [R4]'s daughter .reported to the Social Services Director [V9] that resident was missing $46 from her purse on Tuesday April 1. There were two envelopes, each with $23 inside for [R4] to get her hair done and pay the beautician. Per [R4]'s Daughter the money was in her room on March 19, 2025, and was noticed missing on March 29, 2025 when [R4] went to get her hair done [V9] called Administrator [V10]. [V9] reported to [V10] about the allegation of [R4]'s missing $46 On Friday April 4, [R4]'s daughter reported to Social Service Director [V9] that [R4] had 4 envelopes of money totaling $86 in a zipper pocket of her purse that was located in her rollator and they were missing [V9] completed a Grievance Form to notify [V10] of additional funds missing On April 7, during leadership meeting, Social Service Director, [V9], reported to IDT (Interdisciplinary Team) regarding [R4]'s missing money. Director of Nursing [V2] and [V10], Administrator, immediately initiated full investigation. On 6/4/25 at 12:08 PM, V2 (Director of Nursing) said that she was informed about R4's missing money for the first time on 4/7/25 (6 days after the allegation) during their morning meeting. V2 said that V9 gave her report of what was going on in the facility and she said that R4 was missing money. V2 said that the allegation was not reported to IDPH nor investigated until she heard about it on 4/7/25. V2 said that the facility should always follow their Abuse Policy for any allegations of abuse. V2 said that misappropriation of money is abuse and should not happen. V2 said that all allegations of misappropriation of money should be reported immediately to the administrator and to IDPH and a full investigation should be started immediately. The facility's undated Abuse, Neglect and Exploitation Policy shows, It is the policy of this facility to provide protections for the health, welfare and rights of each resident by developing and implementing written policies and procedures that prohibit and prevent abuse, neglect, exploitation and misappropriation of resident property The facility will have written procedures that include: Reporting all alleged violations to the Administrator, state agency, adult protective services and to all other required agencies within specified timeframes: Immediately, but not later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145443 If continuation sheet Page 4 of 7 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 145443 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Allure of Zion 3615 16th Street Zion, IL 60099 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 0607 Level of Harm - Minimal harm or potential for actual harm bodily injury, or Not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury .An immediate investigation is warranted when suspicion of abuse, neglect or exploitation, or reports of abuse, neglect or exploitation occur. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145443 If continuation sheet Page 5 of 7 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 145443 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Allure of Zion 3615 16th Street Zion, IL 60099 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Based on interview and record review the facility failed to ensure that an alleged misappropriation of resident money was reported immediately to the State Survey Agency for 1 of 4 residents (R4) reviewed for misappropriation of property in the sample of 4. The findings include: A Quality Improvement Form dated 4/1/25 shows that R4's daughter reported to V9 (Previous Social Service Director) that she left two envelopes containing $23 for her to pay to get her hair done. The envelopes were in the room on 3/19/25 and noticed both missing on 3/22/25. The form shows that the administrator was notified. A Quality Improvement Form dated 4/4/25 shows that R4's daughter reported that the resident was missing 4 envelopes of money totaling $86 that were in a zipper pocket of her purse that was located in her rollator walker. The form shows that the administrator was notified. An untitled document dated 4/7/25 to Illinois Department of Public Health (IDPH) shows that R4 reported that she has had money missing, an investigation has been initiated and a five-day final is to follow. The undated Final Investigation related to allegation of missing money from R4 shows, Upon investigation, [R4]'s daughter .reported to the Social Services Director [V9] that resident was missing $46 from her purse on Tuesday April 1. There were two envelopes, each with $23 inside for [R4] to get her hair done and pay the beautician. Per [R4]'s Daughter the money was in her room on March 19, 2025 and was noticed missing on March 29, 2025 when [R4] went to get her hair done [V9] called Administrator [V10]. [V9] reported to [V10] about the allegation of [R4]'s missing $46 On Friday April 4, [R4]'s daughter reported to Social Service Director [V9] that [R4] had 4 envelopes of money totaling $86 in a zipper pocket of her purse that was located in her rollator and they were missing [V9] completed a Grievance Form to notify [V10] of additional funds missing On April 7, during leadership meeting, Social Service Director, [V9], reported to IDT (Interdisciplinary Team) regarding [R4]'s missing money. Director of Nursing [V2] and [V10], Administrator, immediately initiated full investigation. IDPH was notified with initial report On 6/4/25 at 12:08 PM, V2 (Director of Nursing) said that she was informed about R4's missing money for the first time on 4/7/25 during their morning meeting. V2 said that V9 gave her report of what was going on in the facility and she said that R4 was missing money. V2 said that the missing money should have been reported immediately to V1 and herself and an initial report should have been sent to IDPH immediately. V2 said that all allegation of misappropriation of money should be reported immediately to the administrator and to IDPH. The facility undated Abuse, Neglect and Exploitation Policy shows, The facility will have written procedures that include: Reporting all alleged violations to the Administrator, state agency, adult protective services and to all other required agencies within specified timeframes: Immediately, but not later than 2 hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious bodily injury, or Not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145443 If continuation sheet Page 6 of 7 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 145443 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/04/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Allure of Zion 3615 16th Street Zion, IL 60099 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 0610 Respond appropriately to all alleged violations. Level of Harm - Minimal harm or potential for actual harm Based on interview and record review the facility failed to initiate an investigation of an alleged misappropriation of money 1 of 4 residents (R4) reviewed for misappropriation of property in the sample of 4. Residents Affected - Few The findings include: A Quality Improvement Form dated 4/1/25 shows that R4's daughter reported to V9 (Previous Social Service Director) that she left two envelopes containing $23 for her to pay to get her hair done. The envelopes were in the room on 3/19/25 and noticed both missing on 3/22/25. The form shows that the administrator was notified. A Quality Improvement Form dated 4/4/25 shows that R4's daughter reported that the resident was missing 4 envelopes of money totaling $86 that were in a zipper pocket of her purse that was located in her rollator walker. The form shows that the administrator was notified. An untitled document dated 4/7/25 to Illinois Department of Public Health (IDPH) shows that R4 reported that she has had money missing, an investigation has been initiated and a five-day final is to follow. The undated Final Investigation related to allegation of missing money from R4 shows, Upon investigation, [R4]'s daughter .reported to the Social Services Director [V9] that resident was missing $46 from her purse on Tuesday April 1. There were two envelopes, each with $23 inside for [R4] to get her hair done and pay the beautician. Per [R4]'s Daughter the money was in her room on March 19, 2025, and was noticed missing on March 29, 2025 when [R4] went to get her hair done [V9] called Administrator [V10]. [V9] reported to [V10] about the allegation of [R4]'s missing $46 On Friday April 4, [R4]'s daughter reported to Social Service Director [V9] that [R4] had 4 envelopes of money totaling $86 in a zipper pocket of her purse that was located in her rollator and they were missing [V9] completed a Grievance Form to notify [V10] of additional funds missing On April 7, during leadership meeting, Social Service Director, [V9], reported to IDT (Interdisciplinary Team) regarding [R4]'s missing money. Director of Nursing [V2] and [V10], Administrator, immediately initiated full investigation. On 6/4/25 at 12:08 PM, V2 (Director of Nursing) said that she was informed about R4's missing money for the first time on 4/7/25 during their morning meeting. V2 said that V9 gave her report of what was going on in the facility and she said that R4 was missing money. V2 said that the missing money should have been reported immediately to V1 and herself and an investigation should have been started immediately. V2 said that all allegation of misappropriation of money should be reported immediately to the administrator and a full investigation should be started immediately. The facility undated Abuse, Neglect and Exploitation Policy shows, An immediate investigation is warranted when suspicion of abuse, neglect or exploitation, or reports of abuse, neglect or exploitation occur. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145443 If continuation sheet Page 7 of 7