Health inspection·July 5, 2024

F 0567 Honor the resident's right to manage his or her financial affairs. Level of Harm - Minimal harm or potential for actual harm Based on interview and record review the facility failed to provide resident trust fund cash to residents within three business days. This applies to 2 of 3 residents (R6 and R7) reviewed for trust funds in a sample of 8. Residents Affected - Few The findings include: 1. On 7/1/24 at 12:40 PM, R6 stated she waited weeks for her requested trust fund cash. R6 stated the facility told her they were waiting for the check to post. R6 stated the delays in receiving requested trust fund cash was ongoing for a few months and R6 was still waiting for her requested money. Resident (R6) Statement, dated 3/29/24 to 7/1/24, shows on 6/6/24 R6 requested $450.00 from her trust fund. Facility check documentation, dated 6/24/24, shows check number 1009 was issued to V1 (Administrator) on 6/24/24 which included R6's requested $450.00 from her trust fund. On 7/1/24 at 3:13 PM, V12 (Activity Aide / Office Assistant) stated the check for resident trust fund cash requests comes in a little late recently. On 7/1/24 at 3:42 PM, V11 (Activities Director) stated R6 requested $450.00 cash from her trust fund on 6/6/24. V11 stated the check for the cash requests arrived at the facility from corporate on 6/25/24. On 7/2/24 at 10:29 AM, V13 (Business Office Manager) stated the check for the trust fund requests on 6/6/24 was cut on 6/24/24 because that was when resident signatures were provided to corporate for the cash withdrawal requests. V13 stated the requests for trust fund cash were transmitted on 6/6/24 but they were transmitted without resident signatures verifying the cash requests. On 7/1/24 at 12:47 PM, V1 (Administrator) stated she received the check for the trust fund withdrawal requests which was stored in the facility safe and needed to be cashed to disburse the money to the residents. 2. On 7/3/24 at 1:30 PM, R7 stated he had waited a long time for his trust fund cash withdrawals. R7 stated, The checks aren't coming! I'm not getting my money! R7 stated he waited a month for his cash withdrawal when the facility changed banks months ago and the process had not improved. R7 stated he was still experiencing a delay in receiving his cash withdrawals from the facility. (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: 145715 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 145715 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/05/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Wheaton Village Nrsg & Rhb Ctr 1325 Manchester Road Wheaton, IL 60187 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)