Inspection·January 30, 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. Based on interview and record, the facility failed to ensure residents are free from resident-to-resident physical altercation. This failure affected 2 residents (R1,R2) reviewed for abuse in the total sample of 6 residents. Finding include: On 01/27/2025, at 11:43am, R2 stated we (R1 and R2) had a fight. I don't want to talk about it anymore. On 01/27/2025, at 12:21pm, R5 stated the fight happened in the 1st floor dining room. They were to each other's face, talking loudly. Then they start hitting and pushing each other, (R1) hit (R2)'s head and (R2) fell down. On 01/28/2025, at 10:44am, speaking with V11 (Housekeeping Director) and V9 (Housekeeping) stated if there are two residents arguing, the first thing I need to do is to separate them so it will not escalate to physical altercation. On 01/28/2025, at 10:51am, V9 stated I was cleaning room *** or *** when I heard a lot of screaming and I saw (R1) and (R2) were fighting. (R2) pushed (R1). I saw one nurse. This nurse told (R2) to go back to his room on the 2nd floor. I did not see (R2) going back to the second floor because I continued cleaning the room. In about one minute, I was by the door of a room when I heard a loud grunting. Louder than the screaming. I looked and I saw (R1) head locked (R2) with his (R1) left arm. V9 was demonstrating to both surveyor and V11 how (R1) head locked (R2). V9's left upper extremity angled on his left side and V9's right hand holding his left wrist. On 01/28/2025, at 11:09am, V9 stated I did not think the situation would escalate. I did not intervene the first time, I got scared because (R1) is tall and I stand 5'6. On 01/28/2025, at 11:14am, V11 stated I expected him (V9) to intervene and to protect both residents. On 01/28/2025, at 11:30am, V12 (Registered Nurse) stated I was in med room to get insulin for one of my residents. It would not have escalated if only staff intervened while they (R1 and R2) were still arguing. I would still intervene on a safe distance and tell (R1) to calm down and I would have called for other staff to assist. If I cannot manage the situation by myself, I would ask for help. On 01/30/2025, at 10:02am, V18 (Certified Nursing Assistant) stated I did not witness the incident (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 6 Event ID: 145832 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 145832 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ryze at the Ridge 6450 North Ridge Blvd Chicago, IL 60626 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)