Inspection·February 9, 2026

F 0689 Level of Harm - Actual harm Residents Affected - Few Insufficient flush, rinse, or neutralizing of the chemicals from fabric, followed by subsequent drying at high temperature will again intensify chemical action and increase the degree of deterioration to the sling fabric. 2. Temperature or high heat damage. This can occur if the slings are left in the dryer for too long or dried at excessive heat. The Slings are made from plastic fibers and do not absorb as much water and require less drying time than other laundry of natural fiber and fabric. 3. Mechanical/Wash Action can contribute to the accelerated deterioration of the slings, especially if they have been subjected to the above conditions. Slings should be washed using a gentle cycle to minimize excessive agitation and internal fiber abrasion.R1's admission Record dated 12/9/2026 documents, Multiple Sclerosis, Nondisplaced Intertrochanteric Fracture of Right Femur.R1's Care Plan dated 12/9/2026 documents, I have an ADL (Activities of Daily Living) Self Care Performance Deficit related to impaired mobility related to MS (Multiple Sclerosis), and muscle weakness. Revision on: 09/21/2020. TRANSFER: R1 requires Mechanical Aid, (Mechanical Lift) for transfers; Assists x 2 (two people must assist with transferring). Date Initiated: 08/02/2022. Revision on: 03/18/2024.R1's MDS (Minimum Data Set) dated 10/4/2025 section GG documents, Functional Limitation in Range of Motion, Upper extremity, 0 (no impairment) and Lower Extremity 2 (impairment on both sides).R1's MDS dated [DATE] section GG documents, Functional Limitation in Range of Motion, Upper extremity 0 (no impairment) and Lower Extremity 1 (impairment on one side).R1's Emergency History of Present Illness dated 12/9/2025 documents, R1 presents to the emergency department by ambulance for right hip and right arm pain. R1 was being transferred via (mechanical lift) at the nursing home when the mechanical lift sling broke causing R1 to fall onto the bed. R1 denies hitting her head or neck pain. X-ray demonstrates an acute intertrochanteric right femur fracture. Normal humerus X-ray. Orthopedic surgery was consulted. R1 admitted to MS (medical surgical floor) for further treatment.The facility's QA (questions and answers) meeting dated 12/2025 documents, Upon investigation, it was identified that the Housekeeping Supervisor had been responsible for managing (mechanical lift) sling rotation and tracking. When the supervisor resigned from the position, this responsibility was not formally transitioned. The incoming supervisor was not made aware of the established sling rotation and monitoring procedure, resulting in a lapse in oversight. Root Cause Analysis: The root cause was identified as a failure to formally assign and communicate responsibility for Mechanical lift sling rotation and expiration tracking during the supervisory transition, resulting in a lack of consistent monitoring.On 2/9/2026 at 9:00 AM, R1 was in the dining room, in her high-back wheelchair, with a mechanical lift sling underneath her. R1 stated she does not remember her fall. R1 stated that when she is transferred with the mechanical lift, there are two people transferring her. R1 stated she feels safe. R1 stated she does not have any concerns. R1 stated she is pretty sure that she has not had any falls. R1 stated she does have pain in her right hip when being moved around a lot.On 2/9/2026 at 11:00 AM, V3 (Environmental Supervisor) stated that before R1's fall in December, the laundry aides would bleach mechanical lift slings and wash them with sheets. V3 stated she also puts the mechanical lift slings in the dryer and is not sure what the temperature was.On 2/9/2026 at 11:30 AM, V4 (Maintenance) stated the washer temperature goes between 105 degrees Fahrenheit to 110 degrees Fahrenheit. V4 also stated the dryer heat is 177 degrees Fahrenheit.On 2/9/2026 at 10:05 AM, V5 (Laundry Aide) stated that when it comes to washing mechanical lift slings, she is supposed to separate them from everything else in the laundry and only wash mechanical lift slings together on the personals setting. V5 was not sure what the temperature was when washing on the personals setting. V5 stated that once the mechanical lift slings are washed, they go into the dryer that has only one setting. V5 was unsure what temperature the dryer setting was on. V5 stated that once the mechanical lift slings are dry, she is to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145793 If continuation sheet Page 2 of 3 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 145793 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/09/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Renaissance Care Center 1675 East Ash Street Canton, IL 61520 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 0689 Level of Harm - Actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete check them for any damage or fraying of thread on the straps and throughout the sling seams before sending them to each hall for use.On 2/9/2026 at 1:52 PM, V8 (Certified Nurse Assistant) stated she was getting R1 up for dinner on 12/9/2025 using the mechanical lift, and when she looked at the mechanical lift sling before using it on R1, the sling did not look frayed. V8 stated once R1 was up in the air in the mechanical lift, V9 (Certified Nurse Assistant) was guiding R1 into her wheelchair. At that point, V8 stated the right bottom strap on the mechanical lift sling broke, and all V8 saw as R1 falling to the ground. V8 stated that once the management staff came in and looked at the mechanical lift sling, the management staff determined that the straps were dry rotted.On 2/9/2026 at 2:00 PM, V9 (Certified Nurse Assistant) stated that on 12/9/2025, she was with V8 (Certified Nurse Assistant) in R1's room, assisting R1 out of bed and into R1's wheelchair with the mechanical lift. V9 stated that once R1 had her mechanical lift sling underneath her, all four straps attached to the mechanical lift, and seemed fine. V8 started to lift R1 using the remote on the mechanical lift from her bed to her wheelchair. V9 stated she was guiding R1 and positioning R1 to be placed in her wheelchair when R1's bottom right mechanical lift strap broke. V9 stated R1 fell out of the mechanical lift sling, hit the side of the bed, and landed on her right side. V9 stated that once the management staff looked at the mechanical lift sling, the management staff determined the broken strap was dry rotted.On 12/9/2026 at 2:22 PM, V10 (Registered Nurse) stated that on 12/9/2025, V9 (Certified Nurse Assistant) came to get her to tell her R1 had fallen out of her mechanical lift during transferring her from the bed to her wheelchair. V10 stated that when she came into R1's room, R1 was lying horizontally on her right side, lying across the mechanical lift legs, and R1's neck was cranked to the side close to the nightstand. V10 stated it was determined that R1's mechanical lift sling strap had broken, and that was why she fell out of the sling and onto the floor.On 12/9/2026 at 3:32 PM, V2 (Director of Nursing) stated that after R1's fall, it was determined that the mechanical lift sling straps were dry-rotted and that the mechanical lift slings were being improperly washed and dried. Event ID: Facility ID: 145793 If continuation sheet Page 3 of 3