Inspection·December 2, 2025

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. Based on observation, interview and record review the facility failed to ensure a resident was free from verbal abuse for 1 of 3 residents (R3) reviewed for abuse in the sample of 3.The findings include:The findings include:The 11/23/25 resident abuse report form completed by V6 Social Services documents an incident of verbal abuse by V7 Certified Nursing Assistant towards R3. The report states while V7 was assisting R3 with getting ready for breakfast, V7 came into the room and had earphones in her ears and talking to someone in a loud manner and using vulgar language.The 11/14/25 quarterly resident assessment and care screening for R3 documents her to be cognitively intact. She has no behaviors or delusions.On 12/2/25 at 1:25 PM, R3 was sitting in her wheelchair wrapped in a blanket. She was alert and very pleasant. She reached her hand out for a handshake to introduce herself. She recalled the events of 11/23/25. R3 said that day was the first day I had any encounter with (V7). She was helping me go to the bathroom. She had ear buds in and talking to the person on the phone, at first, I thought she was talking to me. Well, whoever she was talking to she started cussing a blue streak, she was using God Damn a lot and I find that offensive. She also was using the F word and Jesus Christ; those words were personally offensive. She was helping me and talking to them, it was very confusing. R3 said her tone of voice was very angry, and it was intimidating. and loud. R3 said she reported it to staff but did not recall which staff member. R3 said V7 made her feel scared if she were to come back, like she would be vindictive, and reported it because she does not want her to do the same thing to anyone else.On 12/2/25 at 2:37 PM, V9 Certified Nursing Aide said R3 reported the aide (V7) was on her phone using lots of foul language. She said the incident was immediately reported to the nurse on duty. V9 said after the incident R3 did seem upset, but not scared, but she definitely was not happy.On 12/2/25 at 2:30 PM, V8 Registered Nurse said an aide had approached her and reported the incident. She called V6 to report the allegation, and V7 was removed from the building. V8 said when she spoke to R3, she appeared very upset about the situation.On 12/2/25 at 1:45 PM, V6 said he received a text message with an allegation of verbal abuse. He then reported to the building to conduct his investigation. V6 said she spoke with the staff on duty, including V7. He said R3 reported to him, V7 was using foul and offensive language while on the phone. She described the language as GD, MF, and JC. V6 said R3 was upset and reported feeling threatened and feared retaliation. V6 said he reviewed the camera footage from outside of R3s room and could see V7 on her phone but was unable to hear anything. When confronted, V7 said she was on the phone but denied using any foul language. V6 said he did believe the incident did occur as R3 reported and is was substantiated as verbal abuse. V7 was not giving the resident the attention she needed. And R3 was shook up after the incident.The facility's undated policy for Abuse, Neglect and Exploitation Policy documents 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. (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: 145495 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 145495 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/02/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Medina Nursing Center 402 South Center Street Durand, IL 61024 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)