Health inspection·October 11, 2023

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 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 report an alleged accusation of misappropriation of resident narcotics. This applies to 10 of 10 residents (R1-R10) reviewed for misappropriation of property in the sample of 10. The findings include: R1-R10 were on narcotics and resided in zones that V3 RN (Registered Nurse) was scheduled to work per facility nursing assignment sheets. On 10/10/23 at 9:33 AM, and 1:40 PM, V2 (Director of Nursing) stated that during suspension of an employee (V6 Certified Nurses Assistant) related to an altercation that occurred involving her and two other Registered Nurses (V3 and V5). V6 stated V3 was taking narcotics from the carts. V2 stated that the altercation had occurred during overnight shift from 10/03/23 to 10/04/23 at 1:30 AM. V2 stated an investigation [for misappropriation of property] was initiated on 10/04/23 when the suspension occurred [for inappropriate staff behavior]. V2 added that a narcotic count of residents was done and residents on PM narcotics were interviewed and no issues were found. V2 stated documentation of the investigation was not recorded. Per request, a synopsis of the above investigation was submitted at around 1:40 PM on 10/10/23. On 10/10/23 at 12:05 PM, and 3:11 PM, V1 (Administrator) stated as follows: I came to know about it because an irate employee [V6] got suspended because of her behavior and she was terminated. V2 knew about the issue before me and she had already investigated it on 10/4/23. It was brought to my attention on Thursday 10/5/23. V2 thought I knew about it on 10/4/23 as she assumed that I heard the conversation she had over the phone with V6. I was outside the office making photocopies and did not hear. V5 resigned and would not talk to us. Because V6 was terminated, V6 stated 'V3 is taking drugs. Everybody knows about it.' We only do a formal investigation and report it to IDPH if there is an allegation [finding]. On 10/10/23 at 2:41 PM, V10 (Corporate Registered Nurse) stated, When an employee [V6 CNA] was notified that she was suspended, in retaliation she responded and made an allegation about the nurse [V3] taking narcotics. The facility did a narcotic count of the whole building and did not find anything. They interviewed residents on V3's unit and they had no complaints. There was no validation of the allegation. It was not reported as no concerns were found. Facility undated policy and procedure on Conducting a Thorough Investigation included as follows: (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 4 Event ID: 145538 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 145538 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/11/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Beecher Manor Nrsg & Rehab Ctr 1201 Dixie Highway Beecher, IL 60401 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)