Inspection·June 13, 2025

F 0578 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure resident's code status was readily accessible to staff by not having the code status documented on the face sheet or in the paper chart/ clinical record. This affected five of five residents (R616, R617, R618, R619 and R166) reviewed for advanced directives. Findings Include: R616 was admitted on [DATE]. R616's face sheet section titled advance directive did not document a code status, it was blank. R616's physician order sheet dated 5/30/25 documents: Full code On 6/11/25 at 4:25pm, R616's entire paper chart was reviewed. No advance directive paperwork was included to indicate R616's code status. The code binder on R616's unit documents: no residents on the do not resuscitate list (DNR) list. V17 (nurse) said, R616's code status was not in his paper chart. V17 said, a resident code status should be in their electronic record and paper chart. R617's was admitted on [DATE]. R617's face sheet section titled advance directive did not document a code status, it was blank. R617's physician order sheet dated 5/28/25 documents: Full code On 6/11/25 at 4:25pm, R617 entire paper chart was reviewed. No advance directive paperwork was included to indicate R617's code status. The code binder on R617's floor documents: no residents on the do not resuscitate list (DNR) list. V17 (nurse) said, R617's code status was not in his paper chart. V17 said, a resident code status should be in their electronic record and paper chart. R618's was admitted on [DATE]. R618's face sheet section titled advance directive did not document a code status, it was blank. Physician order sheet dated 6/5/25 documents: Full code On 6/11/25 at 5:15pm, R618's entire paper chart was reviewed. No advance directive paperwork was included to indicate R618's code status. V3 (don) said, R618's code status was not in his paper chart. V3 said, a resident's code status should be documented in the face sheet, in the resident's paper chart and in their unit binder. R619's was admitted on [DATE]. R619's face sheet section titled advance directive did not document a code status, it was blank. Physician order sheet dated 6/6/25 documents: Full code On 6/11/25 at 4:25pm, R619's entire paper chart did not have any advance directive paperwork to indicate R619's code status. V17 (nurse) said, R619's code status was not in his paper chart. V17 said, a resident code status should be in their electronic record and paper chart. R166's was admitted on [DATE]. R166's face sheet section titled advance directive did not document a code status, it was blank. Physician order sheet dated 5/02/24 documents: Full code. R166's paper chart was observed with an advance directive (POLST) form dated 3/14/14 which documents: attempt resuscitation. On 6/12/25 at 3:00pm, R166's entire paper chart was reviewed. No advance directive paperwork was included to indicate R166's code status. V3 (DON/Director of Nurses) said, R166's code status was not in his paper chart. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 2 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0578 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete On 6/12/25 at 3:00pm, V3 (DON) said, a resident's code status should be on the face sheet, in their chart and on the physician order sheet. Advance Directives Policy and Procedure not dated documents: Upon admission, the facility must determine if the resident executed an advance directive or has given other instruction to indicate what care is desired in case of subsequent incapacity. If the resident/resident legal representative has executed one or more advance directives (executes one upon admission), copies will be obtained and incorporated in the resident medical record. Event ID: Facility ID: 145778 If continuation sheet Page 3 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and records reviewed the facility failed to provide effective interventions to prevent a resident-to-resident physical assault. This affected two of three residents (R568, R277) reviewed for physical abuse. This failure resulted in R277 being assaulted by R568 sustaining a discoloration to his left eye. Findings include: The facility reported incident report states the incident date is 4/4/25. Residents were engaged in a physical dispute. No injuries noted on R568. R277 did appear to have a slight discoloration to the left eye. R568 was transferred to the hospital for further evaluation. Conclusion: No witness were present. R277 alleges that R568 thought he was trying to take his food and he took an aggressive stance towards him. R568 remains in the hospital. R277 is [AGE] years old with diagnosis that include but are not limited to Bipolar Disorder, Schizophrenia, and Major Depressive Disorder. R277's cognition score on 1/13/25 is 15, cognitively intact. Progress note dated 4/3/25 at 12:49PM written by V19, LPN (Licensed Practical Nurse) states R277 was observed with discoloration to his left eye during medication administration this morning. Resident stated the incident happened in the middle of the night. Ordered X-ray. There is no social service note written for R277 related to incident on 4/3/25. R568 is [AGE] years old with diagnosis including but not limited to Major Depressive Disorder, Asthma, Unspecified Psychosis, Attention Deficit Hyperactivity Disorder, Auditory Hallucinations, Schizoaffective Disorder, Non-Compliance with Medical Treatment, and Cannabis Dependence. cognition score on 1/21/25 is 15, cognitively intact. R568 did not return to the facility after the incident for interview. Progress Notes dated 1/7/25 identifies writer received a report that R568 was being aggressive towards staff. Resident became increasingly agitated and attempted to charge at staff. Resident encouraged to attend anger management. Progress Notes 4/3/25 at 11:48AM completed by V19 states resident with agitation and aggression. Transfer to the hospital for psych evaluation. At 12:27PM progress notes states R568 had a physical altercation with another resident. Assessment initiated. At 1:03PM progress notes state R568 had physical altercation with another resident in his room. R568 stated he didn't know why he was physically aggressive. Complete body assessment initiated with no injury occurred. At 1:38PM R568 was transferred to the hospital. R568's care plan states he demonstrates behavioral distress related to poor verbal skills and inability to express self in more appropriate language. Symptoms include verbally aggressive behavior and physically aggressive behavior. This behavior occurs approximately 1 time per week. Interventions include talking to attempt to calm him down. If not successful try walking to a quiet area. Intervene (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 4 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few by speaking calmly and professionally in a soft tone. Additionally, the care plan states R568 has auditory hallucinations. On 06/10/25 at 11:46 AM R277 said the other guy, my roommate he hit me. It happened in the middle of the night. He (R568) said something about the food, I didn't have any. He hit me in the eye. I was in bed sleeping and he came over. On 6/12/25 at 10:54AM V20, LPN, said R277 said his roommate went off on him. We called the administrator and director of nursing. V20 said R277 had an x-ray completed. V20 said R568 was sent out. On 6/12/25 at 11:16AM V21, LPN, said abuse can happen, but it should not happen. We should remove or separate them before an altercation occurs. I make rounds every 30 minutes to make sure the residents are safe. The staff is expected to look in the rooms and look at the residents when doing rounds. On 6/12/25 at 1:30PM V24, Social Service, said if residents are having a behavior we will separate them give them space, sit them down, ask them questions, how they feeling, what medications are they taking. Give them time to breathe. V24 said other staff, nurses, security, will let us know immediately of a resident having behaviors. V24 was asked how do you know who is at risk for abuse? V24 responded we talk to them ask them questions and talk to them on rounds. V24 said rounds are done daily. V24 at the time of the incident with R568 and R277 V23, Social Services, was covering them. V24 said I was not assigned on that floor at that time. On 6/12/25 at 1:55pm V23, Social Services, said neither R568 or R277 were my residents. V23 said in general, if an altercation occurs, I speak with the resident. I report the allegation to the administrator. V23 said if they have behaviors we document them in the progress notes. V23 said to prevent behaviors we look for signs of aggressive behaviors how they talk, if they don't talk, and how they move and intervene. On 6/12/25 at 2:57PM V7, Social Service Director, I was not aware of an incident between R277 and R568. V7 said after an incident occurs we document for 3 days. For an incident we would document on both of them for 3 days. On 6/12/25 at 3:06pm V3, DON (Director of Nursing) said R568 and R277 had a physcial altercation. V3 said they had an argument with them shoving each other. V3 said no one should wake up with an injury. V3 said I am not aware if R568 had behaviors before this one. V3 said rounds by nursing are every 2 hours or more and security staff is doing rounds ever 30 minutes. V3 was asked if the investigation for R277 was an investigation for injury of unknown origin? V3 replied no, it was not. On 6/12/25 at 2:04PM V1, Administrator, said the incident was reported to me by V3, DON. V1 said R277 wasn't forthcoming, and that V19, LPN, had said neither resident told us what happened. V1 said later V19 was told that R277 said R568 was trying to take his food. V1 said R277 did have a red mark under his left eye. V19 reported it happened in the middle of the night and R277 said in the middle of the night. V1 said we feel R568 possibly put his hands on R277. The surveyor requested records of R568's attendance in groups. R568 last group attendance is dated 2/18/25 for Anger management group. The facility reported incident report states the incident date is 4/4/25. Residents were engaged in (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 5 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0600 a physical dispute. Level of Harm - Minimal harm or potential for actual harm No injuries noted on R568. R277 did appear to have a slight discoloration to the left eye. R568 was transferred to the hospital for further evaluation. Conclusion: No witness were present. R277 alleges that R568 thought he was trying to take his food and he took an aggressive stance towards him. R568 remains in the hospital. Residents Affected - Few The facility Abuse Prevention Program dated 11/21/20 states Prevention: the facility desires to prevent abuse, neglect, exploitation, and misappropriation by establishing a resident sensitive and resident secure environment. As part of the social history evaluation and MDS assessments, staff will identify residents with increased vulnerability for abuse .or who have needs and behaviors that might lead to conflict. Through care planning process staff will identify any problems, goals, and approaches which would reduce the chances of mistreatment for these residents. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 6 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0605 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review the facility failed to ensure one resident medication regimen was free from an unnecessary medication by administering one Quetiapine Fumarate 400MG (milligram) tablet without a physician order and failed to reevaluate the use of a psychotropic medications use at least every 14 days. This affected two of five residents (R7, R333) reviewed for unnecessary medications. Findings include: On 6/10/25 at 4:00pm during the medication observation with V25 (LPN/Licensed Practical Nurse), V25 administered R7 divalproex 500MG Extended Release/ 2 tablets, Benztropine 1MG/ 1 tablet, Famotidine 20MG/1 tablet, Olanzapine 20MG/ 1 tablet, Quetiapine Fumarate 400MG/1 tablet, Senna 8.6MG/ 1 tablet and Lorazepam 1MG/1 Tablet. V25 confirmed 8 pills administered to R7. Review of R7 physician order sheet Quetiapine Fumarate 400MG tablet, Olanzapine 20MG/ 1 tablet, is not listed as an active medication, both denoted on the discontinued medication list. R7 medication administration record reviewed, R7 did not have an order for Quetiapine Fumarate 400MG tablet, Olanzapine 20MG/ 1 tablet. On 6/13/25 at 10:00am V3 (Director of Nursing) stated Quetiapine Fumarate 400MG tablet was discontinued for R7, R7 should not have received Quetiapine Fumarate 400MG tablet, Olanzapine 20MG/ 1 tablet. Facility policy Titled Drug Administration, no date noted denotes in-part medication are administered as prescribed, in accordance with good nursing principles and practices and only be person legally authorized to do so. Medications are prepared, administered and recorded only by a licensed nursing, medical, pharmacy or other personnel authorized by state laws and regulations. Ten rights for administration of medications, 1 the right resident, the right drug: verify each drug against the medication record (MAR) before administering. Verify in at least 3 ways, such as by drug's size, shape, color, or label. The right dose, the right time, the right route, the right documentation, the right resident education, the right to refuse, the right assessment, and the right evaluation. R333 was admitted to the facility on [DATE] with a diagnosis of major depression disorder, depression, anxiety, vascular dementia and unspecified psychosis. R333's physician orders dated 3/14/25 documents: Haldol inject 2 mg intramuscularly every six hours as needed for behavioral disturbances related to anxiety. R333's physician orders dated 3/14/25 documents: Haldol 2 mg Give one tablet by mouth every six hours as needed for agitation. R333's progress note dated 4/29/25 documents: patient is not a current danger to herself or others under medication to increase Effexor and discontinue Remeron. Medication reduction indicated documents not attempted due to past reduction attempts resulted in psychiatric instability. Haldol is not listed as a medication in progress note. There is no documentation for the continued use of Haldol. There were no other psychiatric progress notes to review. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 7 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0605 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete On 6/12/25 at 1:45PM, V22 (Psychotropic Nurse) said residents with as needed antipsychotic medications are to have orders for 14 days. After 14 days, the doctor will reevaluate the medications and documents in the chart. Facility policy psychotropic drug usage dated 11/17 documents: Residents who receive as needed psychotropic medications will be evaluated and if the medication is extended longer than 14 days, the rationale for continuations will be documented in the residents' medical record. Event ID: Facility ID: 145778 If continuation sheet Page 8 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0658 Ensure services provided by the nursing facility meet professional standards of quality. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review the facility failed to follow professional standards of care to administer and obtain a physician order prior to administering medications. This affected two of two residents (R188 and R7) reviewed for professional standards of care, physician orders. Residents Affected - Few Findings include: 1. On 6/10/25 at 4:00pm during the medication observation with V25 (LPN/Licensed Practical Nurse), V25 administered R7 divalproex 500MG (milligrams) ER(Extended Release)/ 2 tablets, Benztropine 1MG/ 1 tablet, Famotidine 20MG/1 tablet, Olanzapine 20MG/ 1 tablet, Quetiapine Fumarate 400MG/1 tablet, Senna 8.6MG/ 1 tablet and Lorazepam 1MG/1 Tablet. V25 confirmed 8 pills administered to R7. Review of R7's physician order sheet and medication administration record, R7 did not have an active order for Quetiapine Fumarate 400MG tablet and Olanzapine 20MG/ 1 tablet. 2. On 6/11/25 at 4:52pm during the continuation of medication observation with V15 (Registered Nurse), V15 was observed to administrator R188 Divalproex 500MG ER/ 2 tablets, Benztropine 2MG/1 tablets, Fenofibrate 120MG/ 1 tablet, Fenofibrate 48MG/ 1 tablet, Fluphenazine HCI 10MG/1 tablet, Fluphenazine 5MG/1 tablet, Metformin 1000MG/ 1 tablet, Lispro 18 UNITS subcutaneous (LEFT ARM). V15 confirmed 8 pills administered to R188. Review of R188 physician order sheet, R188 has an order for Clozaril tablet 100mg, give 1 tablet by mouth two times a day related to schizo-affective disorder bipolar type, give one tablet by mouth. Review of R188 medication administration record V15, initials are noted for administering Clozaril 100 mg tablets. During the medication observation with V15, V15 did not administrator Clozaril 100 mg tablet. On 6/12/25 at 4:31pm V15 said she made a mistake she signed out the Clozaril medication, but she did not administer the medication. On 6/12/25 at 3:30pm V3 (Director of Nursing) said his expectation is that the Nurse staff administer medications as order by the physician. Facility policy Titled Drug Administration, no date noted denotes in-part medication are administered as prescribed, in accordance with good nursing principles and practices and only be person legally authorized to do so. Medications are prepared, administered and recorded only by a licensed nursing, medical, pharmacy or other personnel authorized by state laws and regulations. Ten rights for administration of medications, 1 the right resident, the right drug: verify each drug against the medication record (MAR) before administering. Verify in at least 3 ways, such as by drug's size, shape, color, or label. The right dose, the right time, the right route, the right documentation, the right resident education, the right to refuse, the right assessment, and the right evaluation. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 9 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to accurately assess a critical clinical sign (Battle sign) and implement their change in condition policy by failing to immediately activate EMS (emergency medical services) 911 to transport a resident with an acute change in mental status. This affected one of three residents R366 reviewed for change in condition and delay of treatment. This failure resulted in R366 being transported to the hospital and diagnosed with a large traumatic subdural bleed (collection of blood between the covering of the brain and the surface of the brain) with midline shift (displacement of the brain tissue across the midline) causing herniation. Residents Affected - Few Findings include: On [DATE] at 10:10 AM, V17 LPN (Licensed Practical Nurse) stated that V17 worked day shift on the second-floor nursing unit on [DATE]. V17 stated that during initial rounds V17 saw R366 in room and talked to her. V17 stated that R366 was in bed with her face covered up with a sheet; V17 did not see R366's face. V17 stated that when R366 walked to the dining room for breakfast V17 called R366 to come get her medications. V17 stated that is when he observed R366's left eye and left posterior ear discolorations. V17 stated that V17 asked R366 what happened with the left side of her face; R366 rubbed face and informed V17 that she fell last night in her room. V17 stated that R366 stated she tripped and hit the left side of her face on her dresser. V17 stated that V17 asked if R366 told the nurse, R366 stated 'no, she just went back to sleep'. V17 stated that V17 assessed R366 for any other injuries, gave R366 an ice pack, initiated neurological checks, and paged V32 (physician). V17 stated that V32 called and was informed of the incident. V17 stated that V32 ordered a routine facial x-ray. V17 stated that R366 was still walking around during V17's shift. V17 stated that V17 informed staff that R366 cannot leave the nursing unit without a staff member. V17 stated that V17 informed on-coming nurse, V15 RN (Registered Nurse), to not let R366 leave the nursing unit alone. V17 stated that the skin surrounding R366's left eye was black. V17 stated that V17 also observed discoloration behind R366's left ear. On [DATE] at 10:50 AM, dietary mealtimes posted on the second-floor nursing unit notes breakfast is delivered 6:45-6:55 AM. On [DATE] at 10:52 AM, V17 stated that the meal trays are brought up between 6:45 and 6:55 AM and the trays are passed out in the dining room around 7:00 AM. V17 stated that is when V17 observed R366's facial bruising. R366's medical record, dated [DATE] at 9:35 AM, V17 LPN noted R366 was observed with discolorations around left eye and behind left ear. Upon interview with R366, R366 stated that she fell last night in the room and got herself up. R366 stated that she thought that she was fine and didn't report to anyone. V17 encouraged R366 to report incidents timely and to be mindful of her environment to prevent tripping, stated okay. R366 was assessed from head to toe and no other injury noted apart from the discolorations mentioned. R366 denied any pain or discomfort at this time. R366 was placed on observation with staff. Neurological checks were initiated and were normal. Active range of motion was completed with no issue. R366's neurological checks documentation notes it was initiated on [DATE] at 9:45 AM. R366's POS (physician order sheet), dated [DATE] at 9:50 AM, notes an order for facial x-ray due to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 10 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0684 fall. Level of Harm - Actual harm On [DATE] at 3:30 PM, V12 (smoke monitor) stated that he was working on [DATE] from 2:30 PM until 10:00 PM. V12 stated that R366 got a cigarette and sat down to smoke. V12 stated that R366 was on the patio until her smoke break was over at 5:20 PM. V12 stated that when R366 was finished smoking, R366 got up, walked over and placed cigarette butt in the discard container. V12 stated that R366 then walked around garbage can, staggered and fell to the ground hitting head. Residents Affected - Few On [DATE] at 8:53 AM, V31 (Outside Program Employee) stated that V31 works for a program that assists residents to move back into the community. V31 stated that V31 was at the facility on [DATE] at 5:40 PM to visit with two residents. V31 stated that as V31 was signing the logbook at the reception desk, a security guard approached the receptionist and asked for a wheelchair and to have the nurse called because somebody fell on the patio. V31 stated that the receptionist said she would call nurse but did not know where to find a wheelchair. V31 stated that V31 informed them to get a wheelchair from the skilled therapy department. V31 stated that V31 observed R366 being pushed to the elevator; R366 had a dark red purple discoloration to left eye and was complaining her head hurt. V31 stated that V31 rode in the elevator with R366 and got off with R366 on the second-floor nursing unit. V31 stated that staff parked wheelchair with R366 at the nurses' station and the nurse was attempting to obtain R366's blood pressure. V31 stated that V31 visited one resident for 20 minutes. V31 stated that R366 was still in wheelchair at nurses' station with the nurse. V31 stated that V31 left the nursing unit to see another resident. V31 stated that about 6:15 PM V31 heard a code blue paged overhead. V31 stated that afterwards V31 approached the receptionist desk to sign out before leaving facility. V31 stated that V31 saw EMS (emergency medical services) crew arriving at facility. V31 stated that V31 asked the receptionist if the crew was here to get R366 and was informed 'yes'. On [DATE] at 12:35 PM, V16 CNA (Certified Nurse Aide) stated that he worked evening shift on [DATE]. V16 stated that R366 went down to the patio for smoke break. V16 stated that R366 can leave the nursing unit independently to smoke on the patio. V16 denied any staff member that accompanied R366 on that day. V16 stated that V16 does not recall what time it was when V15 RN (Registered Nurse) assessed R366 and screamed call EMS 911. V16 denied calling 911. V16 was unsure who did call 911. V16 denied any other staff coming to the nursing unit to assist V15. On [DATE] at 3:12 PM, V15 RN stated that V15 was coming out of the medication room and escorted R366 to R366's room and immediately assessed R366; R366 had a gash to the left side of her head. V15 stated that V15 obtained vital signs, R366 was lethargic. V15 stated that R366's vital signs were abnormal, oxygen saturation level was decreasing to 87% on room air. V15 stated that she placed R366 on oxygen 2 liters via nasal cannula and oxygen saturation level increased to 95%. V15 stated that EMS crew arrived 10 minutes later. R366's vital sign documentation, dated [DATE] at 5:55 PM, notes blood pressure 104/68, pulse 104 beats/minute, respirations 18 per minute, and oxygen saturation level 87% on room air. At 5:58 PM, oxygen saturation level 95% on oxygen. R366's EMS run sheet, dated [DATE] notes the facility contacted EMS at 6:12 PM for an unresponsive resident. EMS crew was en route to the facility at 6:14 PM, arrived at 6:18 PM, and were at R366's bedside at 6:21 PM. The narrative notes crew dispatched to patient unresponsive with CPR (cardiopulmonary resuscitation) in progress. Upon arrival, R366 laying supine in bed unresponsive with CPR being performed by nursing home staff. Crew advised staff to pause CPR and perform a pulse check on R366. Crew noted R366 had a pulse and was breathing. Crew placed defibrillator pads on R366 and cardiac (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 11 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0684 Level of Harm - Actual harm Residents Affected - Few monitor showed sinus rhythm. CPR discontinued. Staff reported R366 was downstairs outside of facility when she fell and hit her head. Staff reported they brought R366 back to her room in a wheelchair while she was alert and orientated x3 per her normal. Staff reported R366 became unresponsive when getting back to room. Staff reported they put R366 on the bed and initiated CPR because R366 was not breathing. Crew noted hematoma to back of R366's head. R366 presented with battle sign behind left ear. Crew noted R366 had swelling with black and blue discoloration to left eye. Staff reported R366 had a previous fall approximately one day prior to crew arrival. R366 transferred to ambulance. ALS (advanced life support) care initiated. Cardiac monitor showed sinus rhythm. Crew administered oxygen via nasal cannula at 6 liters/minute. Crew noted decreased lung sounds in lower fields bilaterally and some snoring respirations bilaterally in upper fields. R366 presented with dilated pupils. R366 arrived at closest hospital at 6:48 PM. R366's hospital record, dated [DATE] at 6:51 PM, R366 presented unresponsive to the hospital. R366 was noted to have bruising around left eye and around left mastoid. R366 noted to have a large scalp hematoma (swelling). R366 is minimally responsive. R366 is breathing on own but does not respond to pain or voice, does not open eyes. Pupils are fixed and dilated. Given exam, signs of trauma to the head, Battle sign, bruising over the mastoid, R366 was emergently taken for CT (computerized tomography) of head. R366 noted to have a large traumatic subdural with shift causing herniation. There was concern for catastrophic injury. At 7:00 PM, neurological checks noted corneal reflex absent to both eyes. R366 was seen by neurosurgeon who deemed that R366's prognosis was very poor without any chance for any significant functional outcome. The CT scan of R366's head showed a large right cerebral convexity acute subdural hematoma measuring up to 3 cm (centimeters) with severe 1.7cm leftward midline shift, subfalcine and uncal herniation and enlargement of the left lateral ventricle concerning for developing entrapment. R366 expired on [DATE] at 4:40 PM. R366's death certificate was not available for review during this survey. On [DATE] at 3:05 PM, V3 DON (director of nursing) stated that R366's facial Xray was not completed prior to R366 being transferred to the hospital. V3 stated that it was not ordered to be done urgently. V3 acknowledged that given the bruising to R366's left eye and posterior left ear, R366 should have been transferred to the hospital when staff first noted injury earlier in the day. The National Library of Medicine, dated [DATE], notes Battle sign is bruising over the mastoid process and typically requires significant head trauma and may indicate significant internal injury to the brain. It takes Battle sign 1-2 days for the sign to appear. Battle sign is a clinical sign. The facility's change in resident's condition or status policy, undated, notes except in medical emergencies, physician notification will be made within 24 hours of a change occurring in the resident's condition or status. During medical emergencies 911 will be notified for transport to the hospital. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 12 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0688 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to follow physician orders for hand splint and failed to ensure a fabricated right foot orthosis was ordered for a resident with a diagnosis of right drop foot, significant varus of the ankle, weakness of the knee extensor musculature and notable wrist drop, along with weakness of the wrist extensor muscles. This affected one of five resident (R215) reviewed for restorative services. Findings include: R215 was admitted to the facility on [DATE] with a diagnosis of transient cerebral ischemic attack and weakness. During the survey, on 6/10/25, 6/11/25 and 6/12/25 R215 was observed in common areas and room with no right hand splint in place. R215's right arm was flexed at the elbow with right hand fingers contracted. There was no device observed on R215's lower extremities. R215's right foot was observed turning inward. On 6/10/25 at 11:15AM, R215 who was alert and oriented at time of interview said he did not have his splint on today. On 6/11/25 at 1:34PM, R215 who was alert and oriented at time of interview said he did not have his splint on today. On 6/11/25 at 1:50PM, V8 (Restorative Aide) said she will put on residents splints in the morning after breakfast. V8 said she was assigned to R215 today and did not apply R215 splint today. V8 said she forgot and was not placed. V8 did not place splint on R215. On 6/12/25 at 1:16PM, V26 (Restorative Nurse) said splints are applied by staff in the morning after breakfast. V26 was unaware of any changes to R215's right foot and stated staff apply splint to right hand daily. On 6/12/25 at 1:45PM, R215 who was alert and oriented at time of interview said he did not have his splint on today. R215 was observed with no splint to right hand. V26 (Restorative Nurse) said she was unsure why R215's splint was not applied and called V8 (Restorative Aide). V26 said she did not place splint today and unsure reason why. V26 said R215 is alert and oriented and if splint was applied after breakfast it should still be on at this time. On 6/12/25 at 1:16PM, V26 (Restorative Nurse) said staff are expected to place splint after breakfast and leave for on for recommended time. V26 said R215 splint should be on for 6 hours. R215 physician order dated 4/2/25 hand resting splint wear four hours remove for skin check and redness. R215 physician order dated 6/12/25 hand resting splint wear 6 hours on after AM care remove for skin check and redness. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 13 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0688 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few R215's progress note dated 2/11/25: R215 is a pleasant [AGE] year old male, who is evaluated for a right AFO (Foot drop brace) & right Wrist Hand Orthosis. R215 has been diagnosed with right drop foot, significant varus of the ankle, and weakness of the knee extensor musculature. R215 also has notable wrist drop, along with weakness of the wrist extensor muscles. R215 is motivated to walk. To lessen the risk of falls, he would benefit from a custom fabricated right ankle foot orthosis. There is a need to control the ankle in the frontal and sagittal plane. R215 ankle and knee weakness should be addressed and stabilized to assist in ambulation and help to prevent falls. A pre-tibial component is also needed to provide a posterior directed force at the knee to prevent it from buckling. To address the wrist drop, a WHFO (Hand and Finger Splint) is indicated. R215 is motivated to reduce contractures and regain some of his prior function. There is a need to control the wrist, hand, and fingers in the sagittal plane. R215 is anticipated to use the devices for more than 6 months. Due to the above reasons, R215 ankle foot orthosis will require a custom fabrication to offer better control of his joints. Due to the above reasons, R215 wrist hand finger orthosis will require a custom fit to offer better control of his joints. The patient will coordinate the delivery and follow-up visits with the orthotic clinician. On 6/11/25 at 1:50PM, V8 (Restorative Aide) said R215 did not have a splint or brace for lower extremities. On 6/12/25 3:50PM, V3 (DON/Director of Nursing) said any recommendations for therapy devices are ordered by therapy department and unsure about brace for R215's foot. On 6/12/25 at 3:30pm, V26 (Restorative Nurse) was not aware of any previous order for right foot brace On 6/12/25 at 4:19PM, V27 (Therapy) said he recommended brace for R215's right foot in January and gave the information to the restorative nurse. V27 said he is unsure what happened to the order or if it was ordered. Facility was asked to provide documentation that order was place in January for brace but did not present information during the survey. R215's care plan dated 4/2/25 documents splint will be applied 4-6 hours as tolerated daily per the following schedule: apply following morning care. Facility policy dated 2/2015 Range of motion (ROM) and splint policy and procedure documents: once a resident has been evaluated by skilled therapist and the facility has recommendations for the splint; restorative nurse and the skilled therapist will select an appropriate splint and order per vendor. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 14 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. Based on interviews and record reviews, the facility failed to ensure one resident who is incontinent of bladder receives appropriate treatment and services to prevent/ reduce the risk of urinary tract infections. This affects one of three (R239) residents reviewed for infections in a sample of 58. Findings include: On 6/12/25 at 1:06 PM, V22 (Infection Prevention Nurse) stated that V22 meets with infection prevention nurse practitioner weekly to review residents with abnormal laboratory results and/or receiving antibiotics. V22 stated that the nurse is responsible for notifying the physician of all abnormal laboratory results. V22 stated that staff will notify V22 when a resident is prescribed an antibiotic. V22 stated that V22 also gets a printout that identifies all residents on antibiotics. When questioned reason R239's urine culture was reported to this facility on 6/8/25 and physician was not notified until 6/11, V22 stated that she does not know the reason and will have to check with floor nurse. On 6/12/25 at 2:05 PM, V22 stated that V22 spoke with the V28 LPN (Licensed Practical Nurse) who informed physician of urine culture results and obtained an order for an antibiotic on 6/11. V22 stated that V28 informed her that R239 was not complaining of any pain with urination so V28 did not notify physician of culture results. R239 complained of pain on 6/11 so V28 called the physician and obtained an order for antibiotic. On 6/12/25 at 3:10 PM, V3 DON (Director of Nursing) stated that this facility has been having difficulty receiving transmission reports from the outside laboratory company. V3 acknowledged that the nurses are responsible for following up on all outstanding results and should have contacted the outside laboratory company for the urine culture results. R239's urine culture and sensitivity report, dated 6/8/25 at 7:02 AM, notes R239's urine with pseudomonas aeruginosa 50,000 - 100,000 colonies/milliliter. V29 LPN reviewed the urine culture results on 6/11/25 at 2:40 PM. V30 (Attending Physician) was notified of abnormal culture results by V28 LPN on 6/11/25 at 6:00 PM. R239's POS (physician order sheet), dated 6/11/25 at 6:00 PM, notes an order for ciprofloxacin (antibiotic) 500mg (milligrams) twice daily for UTI for seven days. R239's medical record notes R239 received first dose of ciprofloxacin on 6/12/25 at 3:45 PM. The CDC (Center for Disease Control and Prevention), dated 6/12/25, notes Pseudomonas aeruginosa (P. aeruginosa) infections typically occur in healthcare settings. Good hand hygiene and infection prevention and control can help reduce the risk of infection. P. aeruginosa can be resistant to antibiotics, making these infections difficult to treat. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 15 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0759 Ensure medication error rates are not 5 percent or greater. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview, and record review, the facility failed to ensure a medication error rate was less than 5%, by making 3 errors out of 30 attempts with an error rate of 10 %. This affects two of six residents (R7 and R188) reviewed for medication errors. Residents Affected - Few Findings include: On 6/10/25 at 4:00pm during the medication observation with V25 (LPN/Licensed Practical Nurse), V25 administered R7 divalproex 500MG (milligrams)ER (Extended Release)/ 2 tablets, Benztropine 1MG/ 1 tablet, Famotidine 20MG/1 tablet, Olanzapine 20MG/ 1 tablet, Quetiapine Fumarate 400MG/1 tablet, Senna 8.6MG/ 1 tablet and Lorazepam 1MG/1 Tablet. V25 confirmed 8 pills administered to R7. Review of R7 physician order sheet and medication administration record, R7 did not have an active order for Quetiapine Fumarate 400MG tablet and Olanzapine 20MG/ 1 tablet. On 6/11/25 at 4:52pm during the continuation of medication observation with V15 (Registered Nurse), V15 was observed to administrator R188 Divalproex 500MG ER/ 2 tablets, Benztropine 2MG/1 tablets, Fenofibrate 120MG/ 1 tablet, Fenofibrate 48MG/ 1 tablet, Fluphenazine HCI 10MG/1 tablet, Fluphenazine 5MG/1 tablet, Metformin 1000MG/ 1 tablet, Lispro 18 UNITS subcutaneous (LEFT ARM). V15 confirmed 8 pills administered to R188. Review of R188 physician order sheet, R188 has an order for Clozaril tablet 100mg, give 1 tablet by mouth two times a day related to schizo-affective disorder bipolar type, give one tablet by mouth and medication administration. During the medication observation with V15, V15 did not administrator Clozaril 100 mg tablet. On 6/12/25 at 4:31pm V15 said she made a mistake, she signed out the Clozaril medication but she did not administer the medication. During this survey for mediation observation, there was 30 opportunities for errors and 3 medication errors identified, which equates to 10% medication error rate. Facility policy Titled Drug Administration, no date noted denotes in-part medication are administered as prescribed, in accordance with good nursing principles and practices and only be person legally authorized to do so. Medications are prepared, administered and recorded only by a licensed nursing, medical, pharmacy or other personnel authorized by state laws and regulations. Ten rights for administration of medications, 1 the right resident, the right drug: verify each drug against the medication record (MAR) before administering. Verify in at least 3 ways, such as by drug's size, shape, color, or label. The right dose, the right time, the right route, the right documentation, the right resident education, the right to refuse, the right assessment, and the right evaluation. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 16 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observation, interview and record review the facility failed to label all insulin pens and inhalers with open and expiration dates. This affects four of four residents (R154, R261, R60 and R191) reviewed for medication labeling and storage. Findings include: 1. On 6/11/25 at 2:51pm review of medication cart with assist from V33 (Registered Nurse), R154 albuterol inhaler was noted with an open date of 5/27/25, no expiration date noted, R154 Symbicort inhaler noted with open date 5/15/25, no expiration date noted. V33 said the inhaler expires 30 days after opening. V33 said the medication should be dated with an expiration date. 2. R60 Symbicort inhaler, open date 5/18/25, no expiration was date noted, V33 said the inhaler expires 30 days after opening. 3. R261 Albuterol (proair) inhaler was noted to be open, verified with V33, there was no open date or expiration date noted. R261 Trelegy inhaler noted with open date of 5/29/25, no expiration date noted there was no open date or expiration date noted. R261 Lantus insulin pen was noted to be open, verified with V33, there was no open date or expiration date documented on the yellow label on the pen. R261 Aspart insulin pen was noted with an open date of 5/28, no expiration date was documented on the label. V33 said the insulin pens expire 28 days after opening. V33 said the inhaler and insulin pens should be labeled with an open date and expiration date. 4. R191 Novolog insulin pen noted with open date of 6/1/25, no expiration date was documented on the label. V33 said the insulin pen expire 28 days after opening it. V33 said there should be an expiration date documented on the insulin pen. On 6/12/25 V3 (Director of Nursing) said insulin should be dated with an open date and expiration date, V3 said insulin expires 28 days after opening and inhalers expire 30 days after opening or according to manufactures recommendation , V3 said the inhalers should be label with and open date and expiration date. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 17 of 18 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 145778 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/13/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Midway Neurological / Rehab Center 8540 South Harlem Bridgeview, IL 60455 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 0773 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results. Based on interviews and record reviews, the facility failed to notify the attending physician of an abnormal lab result for 3 days after recieving the result. This affected one of three residents (R239) reviwed for abnormal lab results notificaton. Findings include: On 6/12/25 at 1:06 PM, V22 (Infection Prevention Nurse) stated that V22 meets with infection prevention nurse practitioner weekly to review residents with abnormal laboratory results and/or receiving antibiotics. V22 stated that the nurse is responsible for notifying the physician of all abnormal laboratory results. V22 stated that staff will notify V22 when a resident is prescribed an antibiotic. V22 stated that V22 also gets a printout that identifies all residents on antibiotics. When questioned reason R239's urine culture was reported to this facility on 6/8/25 and physician was not notified until 6/11, V22 stated that she does not know the reason and will have to check with floor nurse. On 6/12/25 at 2:05 PM, V22 stated that V22 spoke with the V28 LPN (Licensed Practical Nurse) who informed physician of urine culture results and obtained an order for an antibiotic on 6/11. V22 stated that V28 informed her that R239 was not complaining of any pain with urination so V28 did not notify physician of culture results. R239 complained of pain on 6/11 so V28 called the physician and obtained an order for antibiotic. On 6/12/25 at 3:10 PM, V3 DON (Director of Nursing) stated that this facility has been having difficulty receiving transmission reports from the outside laboratory company. V3 acknowledged that the nurses are responsible for following up on all outstanding results and should have contacted the outside laboratory company for the urine culture results. R239's urine culture and sensitivity report, dated 6/8/25 at 7:02 AM, notes R239's urine with pseudomonas aeruginosa 50,000 - 100,000 colonies/milliliter. V29 LPN reviewed the urine culture results on 6/11/25 at 2:40 PM. V30 (attending physician) was notified of abnormal culture results by V28 LPN on 6/11/25 at 6:00 PM. R239's POS (physician order sheet), dated 6/11/25 at 6:00 PM, notes an order for ciprofloxacin (antibiotic) 500mg (milligrams) twice daily for UTI for seven days. R239's medical record notes R239 received first dose of ciprofloxacin on 6/12/25 at 3:45 PM. The CDC (Center for Disease Control and Prevention), dated 6/12/25, notes Pseudomonas aeruginosa (P. aeruginosa) infections typically occur in healthcare settings. Good hand hygiene and infection prevention and control can help reduce the risk of infection. P. aeruginosa can be resistant to antibiotics, making these infections difficult to treat. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145778 If continuation sheet Page 18 of 18