Health inspection·May 30, 2025

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Based on interview and record review, the facility failed to prevent verbal abuse by a staff member for one resident (R1) and physical abuse by residents for three residents (R3, R5, R7) reviewed for abuse, in a total sample of eight. Findings include: Facility's final incident report date (4.23.2025) documents in part: On 4.17.2025, at approximately 11:40 AM, writer received a report of a verbal altercation between a resident (R1) and employee (V3 LSW-Former Licensed Social Worker) in the 2nd floor dining room. Investigation completed. Based on statements and observations it is determined that employee (V3) was inappropriate in the way she was speaking to the resident. Although the resident was very inappropriate as well and antagonizing towards the employee, it is not acceptable for employees to engage in argumentative behavior or use profanity with residents. The employee has been terminated. On 5.29.2025, at 12:25 PM, via telephone, V8 (LPN-Licensed Practical Nurse) stated, I didn't see it happen (altercation between V3-Former LSW and R1), I heard everything. I heard people arguing. It was during lunch time. As I was rounding the corner with my medication cart, on my may way to the dining room. I saw V3 first, she was yelling F*** you, b****. Then I heard R1 say, no F*** you. Then V3 say, no F*** you. V3 continued to the desk, saying what is her problem? V3 picked up the phone, called someone then ran downstairs. I went downstairs after attending to R1 and reported the incident to V2 (DON-Director of Nursing). V8 stated I also spoke with V2 (Administrator), she took my statement. When asked by surveyor if this was an example of abuse, V8 responded, absolutely, it's abuse, that's why I reported it. On 5.29.2025, at 2:21 PM, V5 (CNA-Certified Nursing Assistant) stated, I was passing trays. I didn't hear exactly how it started. I just heard some loud arguing between V3 and R1. From what I heard, R1 had said a bad word to V3, that's how it escalated. V3 screamed back at R1 using the f word and the b word. It was screaming back and forth, V3 just walked out. She (V3) shouldn't had done that. That's verbal abuse. That was wrong to scream back even though she was overwhelmed. V3 was not available for interview. On 5.29.2025, at 3:07 PM, R1 stated, I was talking to someone, V3 interrupted. I told her (V3), I wasn't talking to you. V3 said, 'you don't tell me what to do. I told her she's always up in people's business and to mind her own business. She said f*** you. I said no, f*** you. She kept repeating that as she was going down the hall. I couldn't believe it. I felt that was abusive, that was so wrong. (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 3 Event ID: 145648 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 145648 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Central Nursing Home 2450 North Central Avenue Chicago, IL 60639 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)