Inspection·March 24, 2025

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to administer medications in a timely manner and ensure a resident's linens were clean. These failures affect one of three (R8) residents reviewed for quality of care in total sample of eight residents. Residents Affected - Few Findings include: R8 is a [AGE] year-old male. R8's diagnoses are but not limited to critical illness myopathy, type 2 diabetes with diabetic neuropathy, chronic obstructive pulmonary disease, dysphagia, weakness, hypothyroidism, polyneuropathy, atherosclerosis, chronic atrial fibrillation, peripheral vascular disease, end stage renal disease, presence of aortocoronary bypass graft, long term use of anticoagulants, and long-term use of insulin. R8's BIMS (Brief Interview for Mental Status) dated 3/23/2025, notes R8 is alert. R8 was admitted to the facility on [DATE]. R8's care plan notes R8 have potential for difficulty in breathing due to chronic obstructive pulmonary disorder and obstructive sleep apnea. R8 requires the use of statin medication due to hyperlipidemia. R8 has a potential for altered cardiac function due to atrial fibrillation, coronary artery disease, and a history of coronary artery bypass graft surgery. R8's POS (Physician Order Statement) notes Atorvastatin Calcium Oral Tablet 40 mg; give one tablet by mouth one time a day for pure hypercholesterolemia. Cinacalcet Bisulfate Oral Tablet 30 mg; given by mouth one time a day for nutritional support. Clopidogrel Bisulfate Oral Tablet 75 mg; given by mouth one time a day related to presence of aortocoronary bypass graft. Lidocaine External Patch 4%; apply to lower back topically one time a day for pain. Renal-Vite Oral Tablet 0.8 mg; given by mouth one time a day related to end stage renal disease. Senna Oral Tablet 8.6 mg; give two tablets by mouth two times a day for constipation. Fluticasone-Salmeterol 250-50 mcg/act aerosol powder; 2 puffs inhale orally two times a day related to chronic obstructive pulmonary disease. Gabapentin Oral Tablet 100 mg; give one capsule by mouth three times a day related to polyneuropathy. On 3/23/2025, at 11:14 AM, R8 stated, I have been here for a week and a day. I think the nurse did give me medication this morning. I have a problem with my memory. My sheets were changed two days ago. I am ready for them to change them today. On 3/23/2025, at 11:16 AM, R8 pulled back the blankets on his bed. There were dried, dark colored stains on R8's sheets. On 3/23/2025, at 11:42 AM, V11 (Registered Nurse) stated, I have not given (R8) his medication today. There are too many residents. I got here before 7:00 AM. Morning medication pass starts after I (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: 145650 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 145650 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/24/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Nexus at Palos 10426 South Roberts Palos Hills, IL 60465 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)