Health inspection·June 20, 2025

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interviews and review of record the facility failed to re-ordered medication on a timely manner for 1 out of 3 residents (R2) reviewed for pharmaceutical services. This practice is not in accordance with their policy and may affect 1 resident (R2) in ensuring pharmaceutical supplies are available to meet the needs of resident. Findings include: R2 is [AGE] years old, initially admitted on [DATE], with medical diagnosis of diabetes mellitus, multiple sclerosis and cerebral infarct. On 06/17/2025, at 10:52 AM, R2 was seen in her room alert and verbally able to express her thoughts well. R2 stated that she does not receive all her medications including eye drops and medication for diabetes. At the nurse's station with V5 (Registered Nurse) all of the medication for R2 in the medication cart was reviewed. After review, there were three (3) medicines that are not available: Glipizide (for diabetes), Metformin (for diabetes) and Trazodone (antidepressant). V5 stated that she just re-ordered Glipizide and Metformin medicines today to the pharmacy. V5 stated that when medication in the bingo card reaches dark colored area it needs to be re-ordered. V5 showed the bingo card that dark blue color once it reaches eight (8) medicines left. V5 re-stated that it needs to be re-ordered to the pharmacy once eight (8) medication left. On 06/17/2025, at 10:50 AM, V2 (Assistant Director of Nursing) stated that nursing staff need to re-order medication on time to ensure medications are available to meet their needs. V2 stated that dark blue area on the bingo card is an indicator that medicine needs to be re-ordered. R2's medication administration record (MAR) on blood sugar monitoring document that R2 have elevated results in certain days. Ordering Medications Policy without a date reads that medications are ordered from the pharmacy on a timely basis. And instructs facility staff to requests for a refill to the pharmacy 72 hours prior to the last dose. Page 1 of 3 145730 145730 06/20/2025 Continental Nursing & Rehab Center 5336 North Western Avenue Chicago, IL 60625

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and review of records, the facility failed to ensure that smoking was done in required designated area. These practices are not in accordance with their policy and State laws and can affect all 144 residents living in the facility as it pertains to their safety and comfort related to smoking effects. Findings include: On 06/17/2025, at 11:18 AM, R3 stated that residents are smoking inside their rooms, common restrooms, shower rooms and other areas not designated for smoking. R3 stated that it is a continuing problem that affects other residents when inhaling cigarettes strong odor. Inside another resident's room, R5 stated that he smelled strong cigarettes odor upon entering the common restroom on the floor. R6 who was outside of R5's room, stated that it is a continuing problem that needs to be addressed. R3 accompanied writer to the common restroom and showed the writer the wall filed with cigarettes marking. When R3 opened the door, a strong odor of cigarettes was smelled. Just outside of the restroom was a crash cart with an oxygen tank attached to the cart. R3 stated that residents are affected by other smoking and he is experiencing breathing problems due to inhaling cigarette smoke. At the nurse station, V3 (Certified Nursing Assistant) was requested to go to the restroom. Upon opening V3 stated Yes, I can smell cigarettes. V3 Went back to the nurse's station and informed V4 (Licensed Practical Nurse) who went to the restroom. Upon opening the door of the restroom, V4 stated, You are right, someone smokes in here. V4 stated that he will notify his supervisor and an investigation will be done about the incident. V2 (Assistant Director of Nursing) who was at the nurse's station was notified. V2 went to the restroom, opened the door, with a strong cigarette odor. V3 pointed to V2 and observed the wall filled with cigarettes marks. After seeing the cigarettes marks on the wall ,V2 said, It is there, I cannot deny that. V3 pointed to V2 and observed an oxygen tank near the restroom. V2 stated, Yes, they should not smoke near oxygen tank. Residents are not allowed to smoke inside the restroom. V1 (Administrator) was made aware about residents smoking in the restroom with an oxygen tank located near the restroom. V1 stated that residents are not allowed to smoke in the restroom and they (residents) are only allowed to smoke in designated areas. Facility Smoking Safety Policy dated 10/05/2015, notes the facility must provide a safe and healthy living environment with respect for the health and well-being needs of each resident, staff members, and visitors. It is also the objective of this policy to communicate to each resident that they are responsible for following each rule and on-going compliance with this policy. Smoking is only allowed in designated areas established by management. If indoor smoking is prohibited by State or local law, the interior of the facility will remain smoke-free at all times. The designated area(s) will be outside in accordance with State/local standards. Public Act [PHONE NUMBER] and Smoke Free Illinois Act both prohibits indoor smoking or similar acts. Smoke Free Illinois Act dated 01/01/2008 reads: The General Assembly finds that tobacco smoke is a harmful and dangerous carcinogen to human beings 145730 Page 2 of 3 145730 06/20/2025 Continental Nursing & Rehab Center 5336 North Western Avenue Chicago, IL 60625

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many and a hazard to public health. Secondhand tobacco smoke causes at least 65,000 deaths each year from heart disease and lung cancer according to the National Cancer Institute. Secondhand tobacco smoke causes heart disease, stroke, cancer, sudden infant death syndrome, low birthweight in infants, asthma and exacerbation of asthma, bronchitis and pneumonia in children and adults. Secondhand tobacco smoke is the third leading cause of preventable death in the United States. Illinois workers exposed to secondhand tobacco smoke are at increased risk of premature death. An estimated 2,900 Illinois citizens die each year from exposure to secondhand tobacco smoke. Also finds that the United States Surgeon General's 2006 report has determined that there is no risk-free level of exposure to secondhand smoke; the scientific evidence that secondhand smoke causes serious diseases, including lung cancer, heart disease, and respiratory illnesses such as bronchitis and asthma, is massive and conclusive; separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate secondhand smoke exposure; smoke-free workplace policies are effective in reducing secondhand smoke exposure; and smoke-free workplace policies do not have an adverse economic impact on the hospitality industry. Further finds that the Environmental Protection Agency has determined that secondhand smoke cannot be reduced to safe levels in businesses by high rates of ventilation. Air cleaners, which are capable only of filtering the particulate matter and odors in smoke, do not eliminate the known toxins in secondhand smoke. The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) bases its ventilation standards on totally smoke-free environments because it cannot determine a safe level of exposure to secondhand smoke, which contains cancer-causing chemicals, and ASHRAE acknowledges that technology does not exist that can remove chemicals that cause cancer from the air. A June 30, 2005, ASHRAE position document on secondhand smoke concludes that, at present, the only means of eliminating health risks associated with indoor exposure is to eliminate all smoking activity indoors. (Source: P.A. 95-17, eff. 1-1-08.) Healthcare Facility means an office or institution providing care or treatment of diseases, whether physical, mental, or emotional, or other medical, physiological, or psychological conditions, including, but not limited to, hospitals, rehabilitation hospitals, weight control clinics, nursing homes, homes for the aging or chronically ill, laboratories, and offices of surgeons, chiropractors, physical therapists, physicians, dentists, and all specialists within these professions. Healthcare facility includes all waiting rooms, hallways, private rooms, semiprivate rooms, and wards within healthcare facilities. The act prohibits smoking including a minimum distance of 15 feet from entrances, exits, windows that open, and ventilation intakes that serve an enclosed area where smoking is prohibited. 145730 Page 3 of 3