Inspection·July 1, 2025

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 interview and record review, the facility failed to prevent abuse between two residents. This applies to 2 of 4 residents (R1, R2) reviewed for abuse in a sample of 5. The findings include: R1 and R2's initial report dated 6/9/25 that was reported to IDPH (Illinois Department of Public Health) shows the following: (R1) allegedly struck (R2) this morning near a common area. Both residents were immediately separated and assessed for any injuries. Police were called and report filed. Medical doctors and Power of attorneys were made aware of the alleged incident. Full investigation to follow. R1and R2's final report shows the following: On 6/9/25, (V4-CNA/Certified Nursing Assistant) was in another resident's room providing care to that resident. Upon exiting the room, she overheard (R1) and (R2) engaged in what appeared to be a physical altercation at the opposite end of the building (West Hallway). (V4) also witnessed (R2) who was standing out of his wheelchair and back to (V4) swinging his arms at (R2). (V4) yelled down the hall to V5 (LPN-Licensed Practical Nurse) and V7 (LPN) that there was an altercation. Both nurses were at the medication room located on the front of the west hallway getting ready to start their medication passes. Both (V5) and (V7) ran to the end of hallway to intervene and separate (R1) and (R2). As the nurses approached, (R1) was observed striking (R2) in the face. (R1) and (R2) were separated immediately and assessed for injuries. (R2) was noted with a small laceration and redness to the left eye/eyebrow area and a bruise to his left hand around his thumb. (R2) reported forearm pain. (R1) was not noted with any injuries and denied pain. (R1) and (R2) were placed on 1:1. The police were contacted along with medical doctors and POA (Power of Attorneys)/Guardian of each resident. (R2)'s doctor gave the order to send him to the hospital for evaluation. Medical doctor for (R1) gave order to send him to a behavioral health hospital for evaluation and treatment. (R1) and (R2) are not interviewable due to their cognitive impairments, however staff attempted to determine a root cause to the incident. (R2) had no recollection of being involved in an altercation and (R1) shrugged his shoulders in response to questioning. Findings: The facility is substantiating abuse as staff did witness (R1) strike (R2) in the face. (R2) has visible injuries while (R1) did not have any. On 6/24/25 at 9:53 AM, R2 stated he did not remember what happened to him and R1. R2's face sheet shows diagnoses of Parkinson's disease without dyskinesia, without mention of fluctuations, Alzheimer's disease, unspecified, and memory deficit following unspecified cerebrovascular disease. R2's MDS(Minimum Data Set) assessment dated [DATE] shows that R2 is severely cognitively impaired. (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 3 Event ID: 145795 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 145795 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/01/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Tower Hill Healthcare Center 759 Kane Street South Elgin, IL 60177 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)