Inspection·May 16, 2025

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Based on interview and record review the facility failed to notify the residents representative psychotropic medications were prescribed. This applies to 1 of 3 residents (R1) reviewed for resident rights in the sample of 4. The findings include: On 5/16/25 at 10:37 AM, V9 (R1's Guardian) said the facility reported R1 was receiving psychotropic medications with my knowledge or consent. V9 said she did not consent for him to receive those medications. When she asked the facility why he was on the medications she was told, R1 would be uncontrollable without the medications. R1's face sheet shows V9 is R1's Guardian. R1's Physician Order Sheets dated May 2025 shows orders including Haloperidol 5 mg (milligrams) every 6 hours as needed for behavior disturbance and Lorazepam 1 mg every 6 hours as needed for behaviors (both order date of 3/4/25). R1's Consent for Psychotropic Medications dated 3/5/25 shows Haloperidol 5 mg and Ativan (Lorazepam) 1 mg listed. The informed consent is signed by V3 (ADON) and signed signature above the resident/authorized Representative/Guardian. On 5/16/25 at 12:10 PM, V3 (Assistant Director of Nursing-ADON) said she over sees psychotropic medications. Consent should be obtained from the resident or resident representative prior to the use of psychotropic medications. At 1:57 PM, V3 said R1 signed his own consent, and she was not aware of R1 having a guardian. V2 (Director of Nursing) confirmed R1 has a guardian, and consents should be signed by the authorized representative. The facility's undated Psychotropic Drug Therapy Policy states, Psychotropic drug therapy will be used only to treat a specific condition .Obtain informed consent. PSYCHOTROPIC MEDICATION SHALL NOT BE PRESCRIBED OR ADMINISTERED WITHOUT THE INFORMED CONSENT OF THE RESIDENT, THE RESIDENTS GUARDIAN OR OTHER AUTHORIZED REPRESENTATIVE . 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: 145714 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 145714 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Oak Park Oasis 625 North Harlem Oak Park, IL 60302 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)