F 0552
Ensure that residents are fully informed and understand their health status, care and treatments.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, interview and record review, the facility failed to inform a resident's Healthcare Power of
Attorney of the provision of atypical care requests. This applies to 1 of 3 residents (R1) reviewed for
resident rights in a sample of 5.The findings include:MDS, dated [DATE], shows R1's cognition was
severely impaired. Grievance dated 12/29/25 shows V4 (Healthcare Power of Attorney) expressed concern
that R1's pubic hair was shaved by a facility CNA (Certified Nursing Assistant) without permission. The
grievance resolution shows education to staff was provided regarding notifying resident power of attorney of
special requests that do not fall within standards listed in facility policy. On 1/14/26 at 11:53 PM, V4 (Family
- Healthcare Power of Attorney) stated she never gave the facility staff permission to shave R1's pubic hair.
On 1/13/26 at 10:53 AM with V2 (Director of Nursing) and V17 (Restorative), R1's pubic area was
examined, appeared to have been recently shaved, and showed approximately 1/4 inch outgrowth of hair.
R1 was asked if she was aware her pubic area was shaved and R1 nodded yes and stated yes. R1 was
then asked if she wanted to have been shaved and R1 shook her head and said no. On 1/13/26 at 9:45 AM,
V2 (Director of Nursing) stated she was informed by V4 (Family - Healthcare Power of Attorney) that R1's
pubic hair was shaved without V4's permission while residing in the facility. V2 stated V4 informed V2 that
shaving R1's pubic area was a dignity issue and staff should not have shaved her mother without
permission. V2 stated she told V4 that V7 (Family) requested that R1's pubic area was shaved in the past.
V4 responded that if R1's pubic hair needed to be trimmed, V4 would trim it herself with scissors she had in
R1's dresser drawer. On 1/13/26 at 10:19 AM, V5 (CNA - Certified Nursing Assistant) stated V7 (Family)
was visiting R1 and told V5 she wanted her mother nice and clean and requested that V5 shave R1's pubic
hair. V5 stated V7 made the request before but supplies were not available at the times of requests. V5
stated she left R1's room to look for razors, found razors, returned to the room, told V7 she found razors,
and V7 replied, Oh, good! V5 stated V7 left R1's room and V5 proceeded to shave R1's pubic area, change
her incontinence brief, then transferred R1 to her wheelchair and dressed R1 before V7 returned to the
room. On 1/13/26 at 12:40 PM, V11 (CNA) stated she was in the room with V5 and assisted V5 in shaving
R1's pubic hair. V11 stated it was clear that V7 requested R1's pubic hair be shaved. On 1/13/26 at 1:45
PM, V7 denied she ever asked staff to shave R1's pubic hair. V7 stated she was aware that all care
decisions needed V4 to be asked because V4 was the decision maker and Healthcare Power of Attorney
for R1's care. V7 stated she had no right to give permission to staff to shave R1's pubic hair. On 1/13/26 at
2:07 PM, V12 (LPN - Licensed Practical Nurse) stated she was not aware of V4 ever asking/approving staff
to shave R1's pubic hair but V7 did ask V12 to shave R1's pubic hair in the past. On 1/14/26, V2 and V14
(Regional [NAME] President of Operations) stated staff were expected to check with residents' healthcare
power of attorney prior to providing any care that families request. V2 and V14 stated any special care
requests outside of typical services should be discussed with the resident's
Residents Affected - Few
(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:
145458
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
145458
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/14/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Alta Rehab at Oak Brook
2013 Midwest Road
Oak Brook, IL 60521
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 0552
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
healthcare power of attorney and V2 prior to delivering the care request. Resident Rights document,
reviewed/approved 1/4/19, shows, Purpose: To promote the exercise of rights for each resident, including
any who face barriers (such as communication problems, hearing problems, and cognition limits) in the
exercise of these rights. A resident, even though determined to be incompetent, should be able to assert
these rights based on his or her degree of capability. Exercising rights means that residents have autonomy
and choice, to the maximum extent possible, about how they wish to live their everyday lives and receive
care, subject to the facility's rules, as long as those rules do not violate a regulatory requirement.
Event ID:
Facility ID:
145458
If continuation sheet
Page 2 of 2