Inspection·May 9, 2025

F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few at least daily until healed. They would document in progress notes the condition of the wound, if it's healing, or if it is getting worse. Treatments done are signed off in the TAR. On 5/6/25 at 2:00 PM, V7 (Registered Nurse) stated that R1's healing skin on her surgical wound peeled off (does not remember the exact date). V7 stated she cleansed the area with normal saline and applied bandage, so R1 won't scratch it. V7 stated she did not notify R1's doctor. V7 stated she notified V10 (Assistant Director Of Nursing/Licensed Practical Nurse) . V7 stated, I put it on the communication board in the computer to notify all the staff. I did not call the doctor. The wound did not look infected. It was not red. No drainage. No pus. She was not complaining of pain. On 5/7/25 at 10:28 AM, V20 (MDS Coordinator) stated that if a resident is at risk for skin breakdown and if there is current wound, it should be addressed in the care plan. If they have acquired wound the care plan should be updated when it has been identified. Residents who were identified with new skin breakdown should be communicated in the electronic health records for all the staff to see and the care plan will be updated as soon as possible. V20 stated that the care plan shows what the staff will do for the resident, what problems they are exhibiting and the interventions on how to address the problems. The care plan goal is to help the staff complete the process. V20 stated that she was notified just last night about R1's surgical wound. V20 stated, I check the communication board every day for any updates with the residents. I was not notified of her [R1] healing surgical wound until last night. 5/6/25 at 1:09 PM, surveyor requested a list of residents with current skin breakdown. The facility provided a list with one resident currently have vascular wound and R1 was not included on the list. R1's clinical records show an admission date of 4/7/25 with included diagnoses but not limited to type 2 diabetes mellitus and cirrhosis of liver. R1's Minimum Data Set, dated [DATE] shows R1 is cognitively intact. R1's progress notes dated 4/7/25 at 6:31 PM documents R1 was admitted in the facility and was noted with a surgical scar on the abdomen. R1's progress notes on 4/17/25 at 9:31 PM, V7 documented in part: [R1] called NOD [Nurse on Duty] to come to her room. On getting to the resident room, resident asked the NOD to take a look at the incision site at the upper middle of the navel. The site was assessed with a little round dry scar that peeled off. Site was cleanse with normal saline and kept dry. Resident request bandage for the site, resident was remind that the site doesn't need bandage for now, that it needs a bit of air to make the surface dry, resident became agitated. Resident was reminded that the wound nurse will assess the site. Wound nurse was notified to see the resident. R1's physician orders and TARs from 4/17/25 to 5/5/25 revealed no treatment order for R1's surgical wound. R1's comprehensive care plan does not have an individualized care plan addressing R1's surgical wound with measurable goals and interventions. The facility's CHANGE IN RESIDENT CONDITION policy dated 1/25 documents in part: It is the policy of the facility, except in a medical emergency, to alert the resident, resident's physician and resident's responsible party of a change in condition. Nursing will notify the resident's physician or nurse practitioner when: It is deemed necessary or appropriate in the best interest of the resident. The resident's care plan will be updated as appropriate. The facility's SKIN MANAGEMENT: Monitoring of Wounds and Documentation policy dated 1/25 documents in part: It is important that the facility have a system in place to assure that the protocols for daily monitoring and for periodic documentation of measurements, terminology, frequency of assessment, and documentation are implemented consistently throughout the facility. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145832 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 145832 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/09/2025 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)

F 0684 Level of Harm - Minimal harm or potential for actual harm The facility's COMPREHENSIVE CAREPLAN policy dated 3/17/25 documents in part: The facility must develop a comprehensive person-centered care plan for each resident. The care plan will include a focus, measurable goal, and interventions specific to the resident's medical, nursing, mantal, and psychosocial needs. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145832 If continuation sheet Page 3 of 3