Health inspection·June 12, 2024

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 protect the residents' right to be free from physical abuse by another resident. This failure affects three of seven residents (R1, R2, R5) reviewed for abuse in the sample of seven. Findings Include: The facility's Abuse Prevention and Prohibition Policy dated January 2024 documents the facility affirms the right of its residents to be free from abuse and free from mistreatment by anyone. Resident behaviors will be monitored for changes, which could trigger abusive behaviors. Resident to Resident abuse includes the term willful. The word willful means that the individual's action was deliberate regardless of whether the individual intended to inflict injury or harm. Physical abuse can include such things as hitting, slapping, punching, and kicking. The Abuse Investigation Summary dated 5/9/24 documents on 5/4/24 staff were wheeling R5 to the dining room and wheeled past R1. Unprovoked, R1 reached out and began punching R5 in the arm. R1 and R5 were separated. After the completion of the facility investigation, the allegation was substantiated. On 6/12/24 at 12:45 PM V6 Certified Nurse's Assistant (CNA) stated she witnessed the incident and observed R1 punch R5 in the arm twice and call him a criminal. V6 stated R1 does not like R5 for some reason. The Abuse Investigation Summary dated 6/3/24 documents on 5/28/24 R2 wheeled up to the table that R1 was sitting at. Unprovoked, R1 yelled that R2 was sitting in her spot and began kicking R2 on the leg. R1 and R2 were separated. After the completion of the facility investigation, the allegation was substantiated. On 6/12/24 at 12:21 PM V5 Certified Nurse's Assistant (CNA) stated she observed R2 wheel up to R1's table and she yelled that it was her seat and R1 kicked R2 in the shin three times. R1's Medical Diagnoses sheet dated June 2024 documents R1 is diagnosed with Dementia with Behavioral Disturbance and Delusional Disorder. R1's Minimum Data Set (MDS) dated [DATE] documents R1 has severe cognitive impairment. R1's Psychosocial Evaluation dated 2/26/24 documents R1 has had new behaviors such as physical Page 1 of 2 145842 145842 06/12/2024 Flanagan Rehabilitation & Hcc 201 East Falcon Highway Flanagan, IL 61740

F 0600 Level of Harm - Minimal harm or potential for actual harm aggression, accusatory, threatening, anger, frustration, agitation. Staff should monitor R1 more closely when she is out of her room and around others. R2's Medical Diagnoses sheet dated June 2024 documents R2 is diagnosed with Depression, Schizoaffective Disorder, and Anxiety. Residents Affected - Few R2's Minimum Data Set (MDS) dated [DATE] documents R2 has a moderate cognitive impairment. R5's Medical Diagnoses sheet dated June 2024 documents R5 is diagnosed with Cerebral Palsy, Schizoaffective Disorder, Depression, Intellectually Disabled, and Explosive Disorder. R5's Minimum Data Set (MDS) dated [DATE] documents R5 has severe cognitive impairment. On 6/12/24 at 1:50 PM V1 Administrator confirmed R1 punched R5 and kicked R2 and this could be considered physical abuse. V1 confirmed both allegations of abuse were substantiated after the facility investigation. 145842 Page 2 of 2