Health inspection·February 28, 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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to keep a resident free from verbal abuse from a staff member. This failure applied to one (R1) of one resident reviewed for abuse. Findings include: R1 originally admitted to the facility on [DATE] and discharged AMA (Against Medical Advice) on 2/26/2025. R1 has multiple diagnoses including but not limited to the following: multiple puncture wounds, pain, mental and behavioral, anxiety, and depression. MDS (Minimum Data Set) dated 2/28/2025 shows R2 has a BIMS (Brief Interview for Mental Status) of a 15 meaning R2 is cognitively intact. MDS dated [DATE] shows R1 has a BIMS of 15 also meaning R1 is cognitively intact. Initial facility reported incident dated 2/23/2025 states in part but not limited to the following: R1 reported V3 (Former Social Service Aide/Smoking Monitor) was verbally inappropriate with residents. R1's witness statement dated 2/23/2025 states in part but not limited to the following: R1 requested a cigarette from V3 during smoking time. V3 refused to give R1 a cigarette and I told her I am a grown man. V3 then told R1 B**ch, you are not getting one. R2's witness statement dated 2/23/2025 states in part but not limited to the following: R1 asked V3 for a cigarette and V3 said no, b**ch. 2/27/2025 at 11:35AM, R2 said I was present on 2/23/2025 when R1 was asking V3 for a cigarette. V3 was standing inside the facility by the cart that contains the resident cigarettes and smoking her own cigarette. V3 was not letting me or R1 smoke. R1 was upset that V3 would not give him a cigarette. They were arguing about it and V3 called R1 'a b**ch.' At 11:13AM, V2 (Licensed Practical Nurse) said after the 1:00PM smoking time on 2/23/2025, R1 came back up to the third floor and told me that V3 was talking to him in an inappropriate way and called him 'a b**ch.' R2 said he was present also at the time and he heard V3 use inappropriate language to R1 as well. R1 was very upset and I brought him to his room to calm down. I called V1 (Administrator/Abuse Coordinator) and a police report was filed. Police Report dated 2/23/2025 states in part but not limited to the following: Complainant needing Page 1 of 2 145639 145639 02/28/2025 Chicago Ridge Snf 10602 Southwest Highway Chicago Ridge, IL 60415

F 0600 to document a verbal aggression towards patient. Level of Harm - Minimal harm or potential for actual harm V3's personal file included a disciplinary action dated 7/3/2023 which read: Employee are presented with unsatisfactory work and/or attitude. Employee noted with dishonest practice regarding the handling of smoking materials. Residents Affected - Few Abuse Prevention Program facility policy and procedure with last review date of 1/4/2019 states in part but not limited to the following: Abuse is defined as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. It includes verbal abuse, etc. 145639 Page 2 of 2