Health inspection·February 2, 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. Based on observation, interview, and record review the facility failed to provide comfortable water temperature for personal cares for 7 of 7 residents (R4, R7, R9-R13) reviewed for comfortable water temperatures in the sample of 13. The findings include: On 2/2/24 at 9:59 AM, the shower room water on the second floor was reading 89 degrees Fahrenheit (F). At 12:10 PM, the second-floor shower room water temperature was reading 86 degrees F and 93 degrees F after 10 minutes of running. On 2/2/24 at 9:50 AM, R10 said the facility has two different showers that can be used and one of them is always cold. On 2/2/24 at 10:00 AM, R11 said, The showers could be warmer, it's not freezing cold, but it is not hot either. On 2/2/24 at 12:51 PM, R7 said the shower room water is cold especially if they do not let it run for a long time before they give you a shower. On 2/2/24 at 11:41 AM, R12 said she just had a shower, and the water was hot and then cold and then hot again and then cold throughout her shower. On 2/22/24 at 12:33 PM, R4's bathroom sink water temperature was reading 90 degrees F. V20 (R4's Spouse) said the water feels warm compared to what it usually is. V20 said it is usually a lot colder than it is now. V20 said it has been a constant problem since December. V20 said when the staff cleans up R4 using the cold water she yells. On 2/2/24 at 12:42 PM, R13's bathroom water temperature was reading 72 degrees F. R13 said the water is always cold and the Certified Nursing Assistants (CNAs) still use it to clean her up. R13 said, I tell them that it is cold and the say, its fine, and continue to use it. R13 said, Have you ever had to get cleaned up with cold water? It's horrible. On 2/22/24 at 12:45 PM, R9's bathroom water temperature was reading 74 degrees F. R9 said the hot water is sometimes freezing cold depending on the time of day. On 2/2/24 at V17 (CNA) said the shower room water does get warm but it has to be on for about 10 minutes or so before it gets warm. (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 2 Event ID: 145803 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 145803 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/02/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Pearl of Evanston,the 820 Foster Street Evanston, IL 60201 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)