Health inspection·July 2, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some On 06/27/2025 at 1:40 P.M. V1 (Administrator) stated it was warmer in the building on Monday, 06/23/2025 than normal. V1 stated that it was just thought that it was hotter than normal outside, so she was not surprised that the building is warmer. V1 stated she monitored the temperatures but did not record anything because the temperatures were within the allotted range. V1 stated that on Tuesday, 06/24/2025, around 12:00 P.M. the east hall and the kitchen temperatures were ranging between 81 and 84 degrees. V1 stated she notified the home office at 3:30 P.M. on 06/24/2025 of the temperatures. V1 stated that the home office then reached out to a heating and air conditioning company to send them to the facility. V1 was told that the company would arrive on Wednesday, 06/25/2025 in the morning. V1 stated they did not come, and she reached out to the home office and was told they were running behind and would be there later Wednesday afternoon. V1 stated the heating and air conditioning company did not show up Wednesday. V1 was told by the home office that the company would be here first thing on Thursday. V1 stated at 3:00 P.M. on Thursday the heating and air company had still not arrived, so she decided to call someone else to come out. V1 stated at 5:00 P.M. she called a local heating and air company, and they came out Thursday 06/26/2025 to look at it. V1 stated she is not sure what was wrong with it but that it was fixed. V1 stated that when the issue first occurred, she was instructed by the home office to turn off the unit to east hall to prevent it from burning up. V1 stated the temperature in the building had been warmer than normal due to the higher temperatures outside. V1 stated they immediately put fans in the hallways to circulate air, and they offered popsicles and encouraged residents to consume extra fluids. V1 stated that no residents had any ill side effects from the heat in the building being higher than normal. V1 stated on Wednesday, the residents were encouraged to eat in their rooms due to the temperatures in the dining room. V1 stated that she checked a few resident rooms but did not document their temperatures. V1 stated that it was hotter in east hallway than in the resident rooms. V1 stated the temperature is better in the facility today than it was on Thursday but feels like it will take some time for the air to catch up since it is 95 degrees outside. On 06/27/2025 at 1:50 P.M. V2 (Director of Nursing) stated that she noticed on Monday, 06/23/2025, that it was warmer in the building than normal. V2 stated that V1 was observing the thermostats, and they were not noted to be above 81 degrees. V2 stated that they tried to get someone to come look at it, but that company was busy, so they had to wait. V2 stated they shut blinds, added fans to the hallways and tried to keep residents out of the dining room because that is where it seemed to be the warmest at. V2 stated the air was working on the far east so they placed fans to blow the air from the far east to the east hall. V2 stated that they had to completely turn off the air to the east hall. V2 stated that they offered a hydration station and passed extra ice water. V2 stated they also passed popsicles for a couple days. V2 stated that they also made activities have smaller groups so that there were no heat related issues. V2 stated that if a resident was observed to have a red face, the resident would get their temperature checked and would get offered a cool washcloth. V2 stated that any resident with a diagnosis with anything lung related was observed first. On 06/27/2025 at 2:30 P.M. a digital metal stemmed thermometer used for taking temperatures for this survey was checked for accuracy using the ice-point method and was accurate within +/_ 2 degrees Fahrenheit (F). On 06/27/2025 2:33 P.M. The following temperatures were taken: East Hall thermostat was registering 78 degrees F. Surveyor thermometer was displaying 79.1 degrees F. North Hall thermostat was registering 81 degrees F. Surveyor thermostat displaying 81.6 degrees F. [NAME] Hall thermostat was registering 80 degrees F. Surveyor's thermometer was displaying 79.9 degrees F. The lounge was 82.7 degrees F on the surveyor's thermometer. The sitting area by the nurse station was 82.4 degrees F on the surveyor's thermometer. At 2:55 P.M. room [ROOM NUMBER], 79.5 degrees (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145760 If continuation sheet Page 2 of 4 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 145760 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/02/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Robinson Rehab and Nursing 600 East Robinwood Drive Robinson, IL 62454 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 - Minimal harm or potential for actual harm Residents Affected - Some F, at 2:57 P.M. room [ROOM NUMBER], 81.1 degrees F. At 2:58 P.M. room [ROOM NUMBER], 81.1 degrees F , at 2:59 P.M. room [ROOM NUMBER], 82 degrees F, at 3:01 P.M. room [ROOM NUMBER], 82 degrees F. On 07/01/2025 at 9:45 A.M. V5 (Certified Nurse Assistant) stated that when the air went down it was miserable on east hall. V5 stated the facility put fans in the hallways but it was still really hot. V5 stated that residents on east hall were complaining about the temperature of the building. V5 stated that everyone was complaining about how hot it was in here. V5 stated there were times when the air was down that she would have to go into the shower room and hose her head down with cold water because it was so hot. On 07/01/2025 at 9:54 A.M. V1 stated that the heating and air company came back out Friday evening to evaluate the units again. V1 stated the front air conditioner was noticed to be blowing warm air again and the heating and air company is here this morning working on it again. V1 stated they have diagnosed the problem as being a coil is out. V1 stated they have gone to get the part and it should be fixed when they get back. V1 stated there were no resident related issues this weekend due to the temperature of the building. On 07/01/2025 at 11:20 A.M. V6 (Registered Nurse) stated when the air was down, the facility put fans in the halls to help circulate air. V6 stated that staff passed extra ice water and would shut some lights off to help with the temperature. V6 stated that she was hot while she was working. On 07/01/2025 at 2:34 P.M. V8 (Maintenance Director) stated he can't remember when he was made aware of the air conditioner issue. V8 stated that when he was told he went out to the unit to look at it. V8 stated he wasn't sure what was wrong with it, but a company was called to come look at it. V8 stated that he was told a compositor was out and it was fixed. V8 stated that it was still warm in certain areas of the building, so they called the company to come back out. V8 stated there is now a coil out of another unit and the company is supposed to be here with the part today to fix it. Facility temperature logs document that on 06/24/2025 temperatures on east hall were at 3:00 P.M. 83 degrees F, at 4:00 P.M. 83 degrees F, at 6:00 P.M. 84 degrees F, at 8:00 P.M. 83 degrees F, and 10:00 P.M. 81 degrees F. Facility temperature logs document that on 06/25/2025 temperatures on east hall were at 7:00 A.M. 80 degrees F, at 9:00 A.M. 81 degrees F, at 11:00 A.M. 83 degrees F, at 1:00 P.M. 84 degrees F, at 3:00 P.M. 84 degrees F, at 5:00 P.M. 84 degrees F, at 7:00 P.M. 83 degrees F, and at 9:00 P.M. 82 degrees F. Facility temperature logs documents that on 06/26/2026 temperatures on the east hall were at 7:00 A.M. 81 degrees F, at 9:00 A.M. 82 degrees F, at 11:00 A.M. 84 degrees F, at 1:00 P.M. 84 degrees F, at 3:00 P.M. 84 degrees F, at 5:00 P.M. 84 degrees F, and at 7:00 P.M. 81 degrees F. Facility document titled Extreme Heat documents extreme heat events are defined as periods when the heat index is 100 degrees or higher for one or more days, or when the heat index is 95 degrees or higher for two or more consecutive days. Prolonged periods of this heat accompanied by high humidity create dangerous situation for vulnerable populations. Elderly residents and those with chronic medical conditions such as cardiopulmonary conditions, high blood pressure and residents with mental illness are at increased risk for heat exhaustion, heat stroke and heat cramps. According to historical climate data found on the website Weather Underground (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145760 If continuation sheet Page 3 of 4 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 145760 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/02/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Robinson Rehab and Nursing 600 East Robinwood Drive Robinson, IL 62454 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 - Minimal harm or potential for actual harm Residents Affected - Some (https://www.wunderground.com/history/daily/us/il/), the highest temperature and humidity levels were recorded for the following dates: 06/24/2025 (Tuesday) at 2:15 PM a temperature of 94 degrees F and 42% humidity level, 6/25/2025 (Wednesday) at 2:53 PM a temperature of 94 degrees F and 49% humidity level, 6/26/25 (Thursday) at 4:53 PM a temperature of 96 degrees F and 46% humidity level, and 6/27/25 (Friday) at 12:53 PM a temperature of 96 degrees F and 41% humidity level. Based on the historical data provided from the Weather Underground website and National Weather Service Heat Index chart, the heat index for the following dates is: 6/24/25 97 degrees F, 6/25/25 97 degrees F, 6/26/25 104 degrees F, and 6/27/25 101 degrees F. The facility provided MDS (Minimum Data Set) Resident Matrix dated 06/27/2025 documented R1-R21 reside on the East Hall of the facility. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145760 If continuation sheet Page 4 of 4