Inspection·September 28, 2024

F 0550 Level of Harm - Minimal harm or potential for actual harm Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Based on interview and record review, the facility failed to ensure call lights were answered in a reasonable amount of time for three of three residents (R1, R2, and R3) reviewed for call lights in the sample of three. Residents Affected - Few Findings include: The facility's Resident Call System policy, dated 9/2022, document's Policy Interpretation and Implementation: 1. Each resident is provided with a means to call staff directly for assistance from his/her bed, from toileting/bathing facilities and from the floor. 6. Calls for assistance are answered as soon as possible, but no later than five minutes. Urgent requests for assistance are addressed immediately. 1. R1's MDS (Minimum Data Set) Assessment, dated 9/16/24, documents R1 is cognitively intact. On 9/27/24 at 9:05 AM R1 stated, Sometimes the call lights have taken longer to be answered, around 30 minutes to an hour. I have had to wait a long time, several times, for someone to answer my call light and I don't like that. Especially when I need help. The facility's Alarm Response Report dated 9/20/24 through 9/27/24, documents R1 waited on 9/20/24- 53 minutes 7 seconds and 56 minutes 1 second, 9/21/24- 37 minutes 25 seconds and 1 hour 57 minutes 23 seconds, and 27 minutes 54 seconds, 9/22/24 - 31 minutes 53 seconds, 50 minutes 27 seconds, and 38 minutes 13 seconds, 9/23/24 - 22 minutes 23 seconds, 9/24/24 -47 minutes 58 seconds, and 29 minutes 49 seconds, 9/25/24 - 1 hour 40 seconds and 44 minutes 51 seconds, and 9/26/24 - 28 minutes 13 seconds. 2. R2's MDS Assessment, dated 7/15/24, documents R2 has moderate cognitive impairment. On 9/27/24 at 9:20 AM R2 stated he does use his call light at times, and it usually takes staff around 10 to 15 minutes to answer his light, but sometimes it's over 30 minutes for staff to answer his call light. R2 stated, It doesn't bother me to wait 10 to 15 minutes, but I don't like waiting 30 minutes or longer. The facility's Alarm Response Report dated 9/20/24 through 9/27/24, documents that on 9/24/24 R2 waited 34 minutes 25 seconds and 9/26/24 -30 minutes 51 seconds. 3. R3's MDS Assessment, dated 9/23/24, documents R3 is cognitively intact. (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 2 Event ID: 145457 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 145457 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/28/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Quincy Healthcare & Sr Living 1440 North 10th Street Quincy, IL 62301 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)