Inspection·June 17, 2024

F 0584 temperatures in degrees Fahrenheit): Level of Harm - Immediate jeopardy to resident health or safety Tour of facility June 12, 2024, with V3: Residents Affected - Many 12:15 PM, R8 and R9's room: 86 degrees. R8 stated he was thirsty, and he had not been provided with a fresh cup of water today. The water cup on R8's table showed the date 6/11/24. R8 stated the water was old and warm. R9 stated, It is too hard to sleep because it is so hot in our room. 12:20 PM, R2 was sitting in her room wearing a sleeveless shirt and shorts. R2 stated she felt very warm in her room. The thermostat in R2's room showed 84 degrees. 12:35 PM, Main dining room: The thermostat in the dining room showed 85 degrees. Multiple residents were present in the dining room eating lunch. V3 pointed the infrared temperature gun at the wall across the room from the wall-mounted thermostat, approximately 20 to 30 feet away. The surface temperature of the wall showed 84.4 degrees on the infrared temperature gun. 12:35 PM, V6 (LPN-Licensed Practical Nurse) stated, I am not taking frequent vital signs on anyone or checking intake and output. We pass water with medication administration but no extra water. 1:19 PM, R36 stated, It is very warm in here. I feel uncomfortable. 1:27 PM, R37 said, We haven't had air conditioning for days. It feels so hot in here, and our rooms are very hot. 1:44 PM, R3 was lying in bed wearing oxygen. R3 had a fan blowing towards her. R3 stated, I am very hot even with the fan blowing on me. The air conditioning unit is throwing out hot air at me. The air blowing from R3's air conditioning unit felt warm. 1:51 PM, R5's room, the thermostat in the room showed 86 degrees. R5 stated, It feels so hot in here. Our rooms are very hot. 6:20 PM, Main dining room. The thermostat mounted on the wall in the dining room showed 91 degrees. R10, R11, R12, and R14 were present in the dining room and did not have water within reach. No staff were present with R10, R11, R12, and R14. R10-R14 stated they felt hot. R12 stated, We don't have a choice, we have to sit here until they take us somewhere else. V1 (Administrator) was immediately notified by this surveyor of the high temperature in the dining room and residents sitting in the dining room without water. 6:21 PM, R8 and R9's room showed 86 degrees on the thermostat in the room. R9 was standing at his bedside and had removed his clothing from the waist down. R9 stated he felt hot and was trying to cool off by removing clothing. R8 stated he felt very hot and asked if this surveyor could get a fan in their room to make the room feel cooler. 6:22 PM, R15 and R16's room, the thermostat in room showed 84 degrees. 6:23 PM, R13's room, the thermostat in the room showed 87 degrees. On June 12, 2024, at 3:34 PM, V7 (VP-Vice President of Service-HVAC Contractor) stated, the facility's air conditioning problems were related to the mechanical issues the facility experienced with (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145694 If continuation sheet Page 2 of 10 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 145694 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Renwick Nursing and Rehab 3401 Hennepin Drive Joliet, IL 60435 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)

F 0584 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Many the lack of heat earlier in the year. V7 continued to say, You cannot measure air temperature with an infrared or laser temperature gun. Those devices only measure surface temperature. For instance, point it at the floor, and you get the temperature of the floor. Point it at the wall and you get the temperature of the wall. Of course, if you point it at the floor, you will get a cooler reading than the actual air temperature in the room. We have been talking to the facility and other facilities in their group. They signed up for preventative service agreements over the past few months. At least a couple of months ago, we identified an issue with their piping for the heating and air conditioning system and we told them they were not going to have air conditioning this year. We told them some major steps needed to be taken and they have called us out on many occasions to try to fix different things. The system is not able to operate because there is a leak underground. If the system is working properly, the system circulates water to all of the rooms. With the pipes broken underground, water just pours out of the cooling tower and into the ground, never reaching the pipes inside the facility. We cannot fill that piping with water because of the leaks, and we cannot locate the broken piping unless we break up concrete and concrete floors in the facility. They were notified on April 12, 2024, about the piping issues, and just authorized isolating the leak on June 10, 2024. We tried to identify where the leak was on Monday, and we found that multiple pipes were leaking. By the end of that day, they knew if could not be fixed. We proposed we would provide temporary cooling that day. We did not receive authorization to move forward with the temporary cooling until just about an hour ago. They have authorized temporary cooling for the four resident wings. We will obtain outside cooling units and temporarily place them outside the facility at the end of their four resident wings. It should be enough cooling to temper the resident rooms enough. We are hoping the cooling capacity will make the rooms comfortable. On April 12, 2024, we sent an email to the facility and notified them they would not have air conditioning this year due to the underground pipe leaks. We did not hear from them, and a month later we touched base with them again, reminding them we could not turn on the air conditioning for them due to the pipe leaks. We never told them we would fix the leaking pipe. They wanted us to repair the cooling tower and I told them we could try to repair the cooling tower. We tried to explain to them that would not fix the problem. An email dated April 12, 2024, from V9 (Account Manager HVAC Contractor) and addressed to the facility Administrator (no name), V4 (VP Plant Operations), and V17 (Corporate Facilities Manager) shows: Subject: [URGENT] Critical Issues - [Facility] HVAC System Piping. We were on site today to assess the HVAC system loop/broken piping. The conclusion is that the piping is in a dire need of being repaired. Without repairs on this piping, [the facility] will have no heating or cooling capacity whatsoever . I would suggest that we have a meeting soon to discuss a plan of action to get this addressed in the timeliest manner possible. An email dated May 9, 2024, at 9:36 AM from V9 (Account Manager HVAC Contractor) and addressed to facility Administrator (no name), V4 (VP Plant Operations), and V17 (Corporate Facilities Manager) shows: Subject: [URGENT] Critical Issues - [facility] HVAC System Piping. Just following up on this matter again. We cannot do any seasonal (cooling) changeover without the piping issues being addressed. Please let me know if you have any questions. Thank you. On June 12, 2024, at 1:55 PM, V4 (VP Plant Operations) stated the facility has problems with water from the cooling tower getting to the building due to broken pipes underground. V4 stated, There are too many leaks in the pipes to fix. I want to say around early May 2024 we started to have trouble with the system. The facility provided a quote for rental cooling systems dated June 11, 2024. The facility does not have any other documentation to show quotes were obtained for rental cooling units prior to June (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145694 If continuation sheet Page 3 of 10 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 145694 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Renwick Nursing and Rehab 3401 Hennepin Drive Joliet, IL 60435 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)

F 0584 11, 2024. Level of Harm - Immediate jeopardy to resident health or safety On June 12, 2024, at 4:06 PM, V1 (Administrator) stated, We were taking room temperatures with an infrared temperature gun. I did not know air temperature could not be checked using those infrared guns. We were not measuring humidity as shown in the policy. We were not checking temperatures and humidity every two hours. I believe we felt we were doing everything we needed to do. It is a complicated problem. There are a lot of different layers. We did not have a conversation about renting temporary chilling units until Monday, June 10. V1 continued to say the facility's air conditioning concerns were not reported to the Department of Public Health. Residents Affected - Many On June 13, 2024, at 10:40 AM, the facility continued to feel very warm inside. V3 (Maintenance Director) stated he did not have the proper device to measure air temperatures or humidity and had not been monitoring the temperatures or humidity readings every two hours. V3 stated he was not aware the facility has a policy to obtain temperature and humidity readings every two hours when the air conditioning is malfunctioning. On June 13, 2024, room temperatures were checked, beginning at 10:50 AM and the following temperature readings were obtained based on the thermostats mounted in the rooms, due to the facility not having the equipment to measure air temperatures (all temperatures in Fahrenheit): June 13, 2024: 10:50 AM, Main dining room, the thermostat on the wall showed 87 degrees. V15 (Activity Aide) was playing a board game with 16 residents. V15 stated the following residents were present in the room: R3, R8, R6, R7, R9, R11, R18, R19, R25, R26, R27, R28, R31, R32, R35, and R40. V15 continued to say, Some residents have complained of feeling hot. No one told me to pass water to the residents or juice. I have not given them anything to drink. The 16 residents did not have water or fluids in front of them, or water visible and available in the room. 11:00 AM, R6 and R7's room, the thermostat showed 82 degrees. R6 stated she felt hot. 11:05 AM, R14's room, the thermostat showed 82 degrees. R14 was present in the room. 11:15 AM, V14 (Cardiology NP-Nurse Practitioner) was in R38 and R39's room. V14 stated the room felt very hot. It has been very hot in the facility since last week. They have to push fluids. These people are more prone to dehydration. Residents with cardiac issues should have input and output monitored when it is this hot in the facility. 11:17 AM, R29 was lying in bed. Her room felt very warm. No thermostat was present in the room to measure the air temperature. R29 was holding an empty plastic cup in her hand and crying, Water, water, I need water. R29 had a meal tray on her bedside table with a cup of lemonade. R29 stated she does not like to drink lemonade because, It is too sweet. R29 continued to call out for water and was unable to turn on her call light. No staff were in the vicinity of R29's room to hear R29 calling for water. No staff were observed passing supplemental water to residents. 11:20 AM, R13's room, the thermostat in the room showed 85 degrees. R13 complained of feeling hot. 11:23 AM, R32's room, the thermostat in the room showed 85 degrees. R32 complained of feeling hot. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145694 If continuation sheet Page 4 of 10 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 145694 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Renwick Nursing and Rehab 3401 Hennepin Drive Joliet, IL 60435 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)

F 0584 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Many 11:25 AM, R33 and R34's room, the thermostat in the room showed 86 degrees. R33 and R34 were present in the room and complained of feeling very hot. R34 stated he was given water during the night and the water at his bedside was now warm and old. A foam drinking cup on the bedside table was dated 6/12/24 NOC (Night). 11:27 AM, R22 was lying in bed and V13 (Son of R22) was present. The thermostat in R22's room showed 88 degrees. R22 was not able to be interviewed due to his medical condition. V13 stated R22's room had felt hot the last two days. 11:30 AM, R23 and R24's room, the thermostat showed 88 degrees. Both residents were present in the room. 11:35 AM, R5's room, the thermostat showed 88 degrees. On June 13, 2024, at 1:15 PM, V10 (Medical Director) stated, I know they found a problem with the air conditioning in April 2024. You need to reach out to the owners of the building about the problem, it is not my job. I am hearing they have rooms that are 86 degrees for the first time from you. No one called me to tell me. This is the first I am hearing about the problem. On June 13, 2024, at 5:00 PM, the facility had obtained a device to measure air temperatures and humidity and the following temperature and humidity readings were obtained with V2 (DON) and V16 (Admissions Director) (all temperatures in Fahrenheit): R14's room, 36.5 percent humidity, 86.6 degrees R23 and R24's room, 36.8 percent humidity, 86.0 degrees R41 and R42's room, 37.2 percent humidity, 86.3 degrees R43's room, 36.8 percent humidity, 86.0 degrees R44 and R45's room, 37.2 percent humidity, 85.6 degrees R46 and R47's room, 36.9 percent humidity, 85.5 degrees R13's room, 38.8 percent humidity, 85.0 degrees R15 and R16's room, 36.7 percent humidity, 84.1 degrees R8 and R9's room, 36.9 percent humidity, 83.2 degrees On June 14, 2024, between 1:20 PM and 1:50 PM, temperature and humidity readings were obtained with V2 (DON) and V16 (Admissions Director) (all temperatures in Fahrenheit): R14's room, 41.8 percent humidity, 84.0 degrees R41 and R42's room, 36.4 percent humidity, 86.3 degrees R23 and R24's room, 41.8 percent humidity, 85.8 degrees (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145694 If continuation sheet Page 5 of 10 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 145694 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Renwick Nursing and Rehab 3401 Hennepin Drive Joliet, IL 60435 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)

F 0584 R43's room [ROOM NUMBER].8 percent humidity, 83.7 degrees Level of Harm - Immediate jeopardy to resident health or safety R44 and R45's room [ROOM NUMBER].6 percent humidity, 84.3 degrees Residents Affected - Many On June 17, 2024, at 9:47 AM, temperature and humidity readings were obtained with V3 (Maintenance Director) (all temperatures in Fahrenheit): R46 and R47's room [ROOM NUMBER].8 percent humidity, 85.6 degrees R22's room, 50.7 percent humidity, 82.9 degrees. R22 was lying on top of his plastic/vinyl mattress with no sheet covering. R22 stated he felt hot and uncomfortable. R21's room, 49.8 percent humidity, 82.2 degrees. Main dining room, 55.4 percent humidity, 83.0 degrees. Eight residents were present in the dining room. R38 and R39's room, 57.6 percent humidity, 80.0 degrees. On June 17, 2024, at 12:04 PM, the thermostat in the main dining room showed the temperature in the dining room was 85 degrees. Lunch was being served to the following residents: R2, R5, R8, R9, R11, R15, R17, R18, R19, R20, R21, R27, R28, R30, R31, R44, R46, R48, R49, R50, R51, and R52. R2, R8, R9, R19, R21, R48, and R50 were asked if they felt uncomfortable and they replied they were warm and uncomfortable. The facility's undated Hot Weather Policy shows: If the air conditioning is not functioning appropriately; follow the following procedure: 1) Temperature and humidity should be measured in several rooms on each floor on unit that has been identified as being the warmest area of each floor or unit. This should be done approximately every two (2) hours during the day and evening. These rooms should include day rooms (activity), dining rooms and hallways. 2) If the facility temperature and humidity combined value falls within the shaded region of the chart for Relative Humidity and Temperature, proceed with the following: i. Fluids (water) should be easily accessible at all times.For additional information, please refer to the Extreme High Temperature Procedure policy. The facility's Extreme High Temperature Guideline revised 04/03/2024 shows: Purpose: To provide guidance to facility in times of unseasonably hot weather and/or cooling system malfunction. Responsible Party: Facility staff. Should the temperature index for relative humidity and temperature in this facility rise above 80 degrees, the facility shall implement the appropriate high temperature procedures. Should a specific area of the facility rise above 80 degrees, it may be necessary to relocate residents to a cooler section of the facility. If the high temperature procedures do not sufficiently maintain resident safety, the facility shall consult with the Department of Public Health regarding the advisability of resident evacuation. Maintenance: Monitor air temperatures at least every 2 hours between 8:00 AM and 10:00 PM in resident areas and every 4 hours between 10:00 PM and 8:00 AM. Temperatures should be taken at the warmest point identified through baseline monitoring on each floor or wing. Include day rooms, dining rooms, activity rooms and resident rooms.Assure that water lines to the building are working appropriately. The facility's undated Summer Temperature Monitoring Policy shows: Purpose to provide a comfortable, safe environment for all residents. To determine if the Hot Weather Policy is to be implemented. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145694 If continuation sheet Page 6 of 10 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 145694 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Renwick Nursing and Rehab 3401 Hennepin Drive Joliet, IL 60435 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)

F 0584 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Many Procedure: a. Routine temperature and humidity monitoring of the facility will occur at a minimum of two times per day during the daylight hours. For example, 10:00 AM and 4:00 PM. These temperatures/humidities are to be taken in the warmest areas of facility identified through baseline monitoring. These values are to be recorded on the bottom of the Temperature and Humidity Chart provided by Public Health. The temperature and humidity combined value is to be determined and circled on the chart. Should the combined value fall in the shaded area of the chart the Hot Weather Policy must be implemented. Should the combined value fall to the right of the heavily darkened line within the shaded area, you must immediately contact the VP of Physical Plant Operations and your VP of Operations. b. Should it be determined that the high temperature procedures do not sufficiently maintain resident safety for an extended period of time determined by facility Administrator in concert with the VP of Plant Operations, VP of Regional Operations and the Chief Operating Officer, the facility will consult with Public Health regarding the advisability of resident evacuation . The facility presented an abatement plan to remove the immediacy on June 13, 2024, at 2:11 PM. The survey team reviewed the abatement plan and was unable to accept the plan to remove the immediacy. The abatement plan was returned to the facility for revisions. The facility presented a revised abatement plan on June 13, 2024, at 5:40 PM. The survey team reviewed the abatement plan and was unable to accept the plan to remove the immediacy. The abatement plan was returned to the facility for revisions. The facility presented a revised abatement plan on June 14, 2024, at 2:17 PM. The survey team reviewed the abatement plan and was unable to accept the plan to remove the immediacy. The abatement plan was returned to the facility for revisions. The immediate jeopardy that began on April 12, 2024, was not removed at the time of the survey exit because the facility failed to provide a removal plan showing a date for when their heating, ventilation and air conditioning system will be fixed permanently. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145694 If continuation sheet Page 7 of 10 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 145694 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Renwick Nursing and Rehab 3401 Hennepin Drive Joliet, IL 60435 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)

F 0835 Administer the facility in a manner that enables it to use its resources effectively and efficiently. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the administration failed to provide oversight and leadership to ensure hot weather policies and procedures were followed when the facility's air conditioning was not functioning properly. V1 (Administrator) was aware the facility did not have functioning air conditioning and did not ensure temperature and humidity levels were being checked as shown in the policy Residents Affected - Many This applies to all 98 residents residing in the facility. The findings include: The Facility Data Sheet dated June 12, 2024, shows the facility census as 98 residents. On June 12, 2024, at 11:42 AM, V1 (Administrator) was not present in the building. V2 (DON-Director of Nursing) stated, They are still working on the air conditioning situation. We have some portable air conditioners in the hallways and fans. On June 12, 2024, at 12:00 PM, V3 (Maintenance Director) stated he uses an infrared temperature gun to measure surface temperatures. V3 continued to say he does not have a thermometer to measure air temperatures or a device to measure humidity. V3 was not aware temperature and humidity readings should be checked every two hours when air conditioning is malfunctioning. On June 12, 2024, between 12:15 PM and 1:51 PM, the following room temperatures were obtained using thermostats in resident rooms and common areas (all temperatures in Fahrenheit): 12:15 PM, R8 and R9's room: 86 degrees. 12:20 PM, R2's room: 84 degrees. 12:35 PM, Main dining room. The thermostat in the dining room showed 85 degrees. Multiple residents were present in the dining room eating lunch. 1:19 PM, R36 stated, It is very warm in here. I feel uncomfortable. 1:27 PM, R37 stated, We haven't had air conditioning for days. It feels so hot in here, and our rooms are very hot. 1:51 PM, R5's room, the thermostat in the room showed 86 degrees. On June 12, 2024, at 4:06 PM, V1 (Administrator) stated the room temperatures were being checked using an infrared temperature gun. V1 stated she did not know air temperatures could not be checked using the infrared guns. V1 continued to say the facility does not have a device to measure humidity percentage and was not checking humidity levels. V1 also stated the facility was not checking temperatures and humidity levels every two hours as shown in the facility's policy. V1 stated, I believe we felt we were doing everything we needed to do. V1 continued to say the State Agency was not notified of the facility's air conditioning not functioning appropriately. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145694 If continuation sheet Page 8 of 10 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 145694 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Renwick Nursing and Rehab 3401 Hennepin Drive Joliet, IL 60435 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)

F 0835 Level of Harm - Minimal harm or potential for actual harm On June 12, 2024, at 6:20 PM, the thermostat mounted on the wall in the dining room showed 91 degrees. R10, R11, R12, and R14 were in the dining room without available water. No staff were present. V1 (Administrator) was immediately notified by this surveyor. On June 12, 2024, at 6:21 PM, R7 and R8's room showed 86 degrees on the thermostat in the room. Residents Affected - Many On June 12, 2024, at 6:22 PM, R15 and R16's room showed 84 degrees on the thermostat in the room. On June 13, 2024, at 10:40 AM, V1 (Administrator) stated the facility did not have a device to measure humidity levels or air temperatures and the air conditioning was not functioning appropriately. On June 13, 2024, at 10:50 AM, the facility continued to use the main dining room. Sixteen residents were sitting in the dining room when the thermostat on the wall showed 87 degrees. V15 (Activity Aide) was playing a board game with the 16 residents. V15 said the following residents were present in the room: R3, R8, R6, R7, R9, R11, R18, R19, R25, R26, R27, R28, R31, R32, R35, and R40. V15 stated she was not told to pass water to the resident. No residents had water in front of them. On June 13, 2024, at 5:00 PM, the facility had obtained a device to measure air temperatures and humidity. Resident room temperatures continued to be elevated in the absence of functioning air conditioning. The following temperature and humidity readings were obtained with V2 (DON) and V16 (Admissions Director) (all temperatures in Fahrenheit): R14's room, 36.5 percent humidity, 86.6 degrees R23 and R24's room, 36.8 percent humidity, 86.0 degrees R41 and R42's room, 37.2 percent humidity, 86.3 degrees R43's room, 36.8 percent humidity, 86.0 degrees R44 and R45's room, 37.2 percent humidity, 85.6 degrees R46 and R47's room, 36.9 percent humidity, 85.5 degrees R13's room, 38.8 percent humidity, 85.0 degrees R15 and R16's room, 36.7 percent humidity, 84.1 degrees R8 and R9's room, 36.9 percent humidity, 83.2 degrees The facility's undated Hot Weather Policy shows: If the air conditioning is not functioning appropriately; follow the following procedure: 1) Temperature and humidity should be measured in several rooms on each floor on unit that has been identified as being the warmest area of each floor or unit. This should be done approximately every two (2) hours during the day and evening. These rooms should include day rooms (activity), dining rooms and hallways. 2) If the facility temperature and humidity combined value falls within the shaded region of the chart for Relative Humidity and Temperature, proceed with the following: .For additional information, please refer to the Extreme High Temperature Procedure policy. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145694 If continuation sheet Page 9 of 10 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 145694 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Renwick Nursing and Rehab 3401 Hennepin Drive Joliet, IL 60435 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)

F 0835 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many The facility's Extreme High Temperature Guideline revised 04/03/2024 shows: Purpose: To provide guidance to facility in times of unseasonably hot weather and/or cooling system malfunction. Responsible Party: Facility staff. Should the temperature index for relative humidity and temperature in this facility rise above 80 degrees, the facility shall implement the appropriate high temperature procedures. Should a specific area of the facility rise above 80 degrees, it may be necessary to relocate residents to a cooler section of the facility. If the high temperature procedures do not sufficiently maintain resident safety, the facility shall consult with the Department of Public Health regarding the advisability of resident evacuation. Maintenance: Monitor air temperatures at least every 2 hours between 8:00 AM and 10:00 PM in resident areas and every 4 hours between 10:00 PM and 8:00 AM. Temperatures should be taken at the warmest point identified through baseline monitoring on each floor or wing. Include day rooms, dining rooms, activity rooms and resident rooms.Assure that water lines to the building are working appropriately. Temperatures observed during this investigation show temperatures in the facility exceeding 85 degrees Fahrenheit for greater than four hours. The facility's undated Rapid Response Guide: Extreme Weather - Heat shows: The determination of what constitutes excessive heat should be tailored to the impact of the temperature and its duration on the health and well-being of the facility's residents. An informed decision should be made by responsible facility administrators. A suggest guideline to consider is a facility temperature of 85 degrees Fahrenheit or higher for a period of four hours. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145694 If continuation sheet Page 10 of 10