Health inspection·August 24, 2023

F 0759 Ensure medication error rates are not 5 percent or greater. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to administer medications at ordered times. There were 31 opportunities with 4 errors resulting in a 12.9% medication error rate. Residents Affected - Few This applies to 2 of 5 residents (R2,R6) observed in the medication pass. 1) R2's electronic face sheet printed on 8/24/23 showed R2 has diagnoses including but not limited to chronic kidney disease stage 2, major depressive disorder, anxiety disorder, hypertensive heart and chronic kidney disease with heart failure, and long term use of anticoagulants. R2's medication administration record (MAR) for August 2023 showed R2 is to receive Flecainide Acetate 100mg and Apixaban 5mg every 12 hours at 9:00AM and 9:00PM. On 8/24/23 at 10:32AM, V4 (Registered Nurse) administered R2's Flecainide Acetate and Apixaban. (1 hour and 32 minutes past the scheduled administration time). On 8/24/23 at 10:37AM, V4 stated medications are considered late and a medication error if given over an hour beyond the scheduled administration time. V4 stated her medication pass for the morning is very heavy and she gets to all of the residents as soon as she is able but her medications are almost always late. On 8/24/23 at 11:45AM, V2 (Director of Nursing) stated, A medication that is given over one hour after the scheduled administration time would be considered a medication error. I know this is a problem in our facility and we are going to correct it. I've spoken with a few nurses and told them they need to go faster with their medication pass but I'm not sure what else to do. Nursing management typically does not help with medication pass because the floor nurses are responsible for managing their time to get the medication pass done on their own. The facility's policy titled, Medication Administration dated 03/2021 showed, Policy: To ensure that medications are administered safely as prescribed. 8. Medications are administered within one hour of prescribed time. Unless otherwise specified by the physician, routine medications are administered according to established medication administration schedule. 2) R6's electronic face sheet printed on 8/25/23 showed R6 has diagnoses including but not limited to Parkinson's disease, hypertension, and hemiplegia and hemiparesis following cerebral infarction. R6's medication administration record for August 2023 showed R6 is to receive Lyrica 50mg and Potassium Chloride ER 40meq at 9:00AM and 5:00PM. (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: 145582 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 145582 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/24/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Alden Estates of Naperville 1525 South Oxford Lane Naperville, IL 60565 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)