Health inspection·June 24, 2024

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to maintain resident room air temperatures at a comfortable temperature. This applies to 9 of 9 residents (R1-R8 and R11) reviewed for homelike environment in a sample of 11. The findings include: 1. The electronic medical record showed R1 was admitted to the facility on [DATE]. On 6/20/24 at 11:22 AM, V5 (R1's Family) stated This room is too hot! V5 stated she complained that the room was hot since R1 moved into the facility but the room remained hot. R1 and R2 stated the room had been too hot for days. There was cool air slowly blowing from the air conditioning unit in the room, but the room was very warm and felt very humid and felt much warmer than the hallway air temperature. V3 (Maintenance) stated he replaced and flushed the air conditioner unit water lines the prior week. Facility Concern/Response Form, dated 6/20/24, shows V5 expressed concern that R1's room was too warm and there was not enough circulation in the room. The form shows V5 stated someone previously checked the air conditioner but the room had not cooled off enough. The form shows R1 was moved from her warm room to a room on the first floor. 2. On 6/20/24 at 11:24 AM, R3 stated, Today is better - yesterday was really hot. We close our shades but it's still too hot! R3's room was very warm and there was a small amount of cool air blowing from her air conditioner unit. On 6/20/24 at 1:49 PM with V3 (Maintenance) and V4 (Journeyman- Contract Company), R3's room air temperature measured 78 egress F (Fahrenheit) and the humidity measured 60% when measured with a psychrometer. 3. On 6/20/24 at 11:25 AM, R4 stated, It gets too hot sometimes! We close our shades but it's still too hot! R4's room was very warm and there was a small amount of cool air blowing from her air conditioner unit. On 6/20/24 at 1:49 PM with V3 and V4, R4's room temperature measured 78 degrees F and the humidity measured 58% when measured with a psychrometer. Page 1 of 3 145737 145737 06/24/2024 Bella Terra Lagrange 4735 Willow Springs Road LA Grange, IL 60525

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 4. On 6/20/24 at 11:27 AM R5 stated, It's been very warm in here! R11 stated, This is an old system - it's been hot in this room since the heat wave outside. R5 and R11 both stated they felt uncomfortable in their rooms due to the warm temperatures in their room. The room temperature felt very warm and humid. On 6/20/24 at 1:49 PM with V3 and V4, R5 and R11's room temperature measured 78 degrees F and the humidity measured 59% when measured with a psychrometer. 5. On 6/20/24 at 11:38 AM, R6 and R7 both stated the room was too hot and both residents stated they were uncomfortable. The room temperature felt hot and humid. R6 and R7's air conditioner had no air blowing from the unit when the unit was set on high and the temperature was set to 50 degrees F. Changing the settings on the air conditioning unit did not result in any air blowing from the unit. On 6/20/24 at 1:49 PM with V3 and V4, R6 and R7's room temperature measured 79 degrees F and the humidity measured 57% when measured with a psychrometer. On 6/20/24 at 1:15 PM, V3 and V4 stated R6 and R7's air conditioning unit was repaired after replacing and flushing the water lines. V4 stated with the age of the building and air conditioners, as well as the poor insulation of the older building, the resident air conditioners had difficulty keeping up with the hot temperatures. 6. On 6/20/24 at 11:43 AM, R8 stated, At night it's too hot in here and you can't sleep! It's always hot! R8 stated the small amount of cool air that blew through the air conditioner only stays in front of the air conditioner unit and did not circulate in the room. R8 stated, The only way you get air is if you sit on the unit! The air conditioner unit had a small amount of cool air lightly blowing from the unit and the room was very warm. 7. Concern/Response Form, dated 6/3/24, shows V6 (Family) shared a concern regarding R9 that the air conditioning was not as cool as it should be. The form shows, Maintenance checked the air conditioning and was blowing 66 degrees F. Maintenance showed V6 on thermometer. 8. Review of facility outdoor temperature history showed the outdoor daily high temperature measurements were as follows: 6/16/24 96 degrees F 6/17/24 97 degrees F 6/18/24 95 degrees F 6/19/24 95 degrees F 6/20/24 86 degrees F Facility Concern/Response Form, dated 6/19/24, shows an unidentified caller phoned the facility and stated her loved one was complaining the resident was hot. The form shows the caller would not provide the resident's name and stated the facility needed to check all of the resident room temperatures. The form shows V3 was asked to take temperatures on all of the rooms in the second floor and document. 145737 Page 2 of 3 145737 06/24/2024 Bella Terra Lagrange 4735 Willow Springs Road LA Grange, IL 60525

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Review of second floor room temperature logs measured with a surface laser thermometer, dated 6/19/24, show second floor room surface temperatures fluctuated between 72-77 degrees F. No room air temperatures were taken utilizing a psychrometer. On 6/20/24 at 10:57 AM, V3 (Maintenance) stated on 6/19/24 he was using a laser thermometer to check surface temperatures in resident rooms and did not have a psychrometer at the facility to measure air temperatures in the resident rooms. V3 stated the humidity in the building was fluctuating between 55-60% and the resident room surface temperatures measured between 75 and 77 degrees F. Facility electronic hall thermometer measurement document shows on 6/17/24 at 7:00 PM the temperature in the second floor hallway measured 79.9 degrees F. The document shows on 6/18/24 at 7:00 PM the temperature in the second floor hallway measured 79.9 degrees F and on 6/19/24 at 7:00 PM, the temperature of the second floor hallway measured 80.2 degrees F. On 6/20/24 at 11:43 AM during initial tour of the facility, the second floor South hallway air temperature measured 77.9 degrees F (Fahrenheit) and the second floor nursing station room air measured 77.4 degrees F. On 6/20/24 with V3 and V4 at 1:44 PM, the second floor dining room had several residents sitting in the room and V3 measured the room temperature at 79 degrees F and humidity at 61% using a psychrometer. V3 also measured the temperature/humidity in the South resident hallway which measured 78 degrees F and 61% humidity. V3 and V4 stated the second floor main air conditioner chilled water pump was not working and had just been repaired. Temperature/humidity measurements taken from random resident rooms on the second floor ranged from 76.6-79 degrees F and 55-62% humidity. On 6/24/24 at 1:32 PM, V3 stated he did not begin taking any resident room temperatures when the outdoor temperatures rose above 80 degrees. V3 stated the only day he took resident room temperatures was on 6/19/24 which were taken using the laser surface temperature thermometer. Facility Policy Extreme High Temperature & Hot Weather, reviewed 7/27/23, shows, The following hot weather and extreme high temperatures precautions have been established for all personnel to follow during the hot weather of summer (outdoor temperatures climb into the 80's and above ) 4. Check air conditioning of residents and encourage fluid intake 7. Maintenance department to conduct random temperature checks of resident rooms and resident common areas. z. Administrative Code: Zones of Physiological Perception Comfort Level (68-75 degrees F) Facility Policy Ambient Temperature, reviewed 7/27/23, shows It is the facility's policy to ensure that facility ambient temperature remains at comfortable level. Procedure: 1. Keep temperature level all throughout the facility between 71 F to 81 F. 2. Ensure residents are comfortable 3. In extreme hot temperature, facility's hot temperature procedure should be activated. 145737 Page 3 of 3