Health inspection·July 9, 2025

F 0550 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Level of Harm - Minimal harm or potential for actual harm Based on interview, record review and Residents Affected - Few observation, the facility failed to protect and promote residents rights for 1 of 3 (R1) residents reviewed for resident rights in a sample of 12. Findings included: R1's admission record documented R1 was admitted to this facility on 6/18/2025, with diagnoses of sepsis due to methicillin susceptible staphylococcus aureus, infection and inflammatory reaction due to cardiac and vascular implant device and presence of cardiac pacemaker. R1's admission record documented R1 has an expected length of stay to be 21 days. R1 is alert and oriented. R1's care plan with admission date of 6/18/2025 documented R1 has a focus area of: (R1) has a functional self care performance deficit r/t (related to) recent hospital stay, weakness and Page 1 of 8 145863 145863 07/09/2025 Integrity Hc of Marion 1301 East Deyoung Marion, IL 62959

F 0550 deconditioning. (R1) is independent for most Level of Harm - Minimal harm or potential for actual harm functional tasks. (R1) is independent for eating. (R1) is able to perform most bed mobility tasks Residents Affected - Few independently. (R1) is continent of bowels and bladder. (R1) is able to ambulate with supervision. (initiation date of 6/26/2025). Care planned interventions included: Discuss with resident/family any care concerns related to loss of independence or decline in function and encourage (R1) to use the bell (call light) to call for assistance. R1's care plan does not include a plan of care for R1's physical restraints, R1's preferred activities, R1's ability to have personal property or R1's right to communicate with family or use a telephone. R1's admission contract documented the following: The contract between resident and facility is made as of June 19, 2025 by and between (R1) and (the facility's name) located at (the facility's address). The contract outlines the residents rights and obligations after being admitted to this facility. Under the section titled Attachment J: Statement of Resident Rights, is documented in part: No resident shall be deprived of any rights benefits, or privileges guaranteed by 145863 Page 2 of 8 145863 07/09/2025 Integrity Hc of Marion 1301 East Deyoung Marion, IL 62959

F 0550 law, the Constitution of the State of Illinois, or the Level of Harm - Minimal harm or potential for actual harm Constitution of the United States, nor shall a resident forfeit any of the following rights: Residents Affected - Few A. Residents Rights: The resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility. The facility must treat each resident with respect and dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement of his quality of life. The facility must protect and promote the rights of the resident. E. Respect and Dignity: The resident has a right to be treated with respect and dignity including the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience and are not required to treat the resident's medical symptoms. The right to retain personal possessions. F. Self-Determination: The resident has the right to and the facility must promote and facilitate resident self-determination through support of resident choice. The resident has a right to choose activities, schedules and health care 145863 Page 3 of 8 145863 07/09/2025 Integrity Hc of Marion 1301 East Deyoung Marion, IL 62959

F 0550 services consistent with his interests, Level of Harm - Minimal harm or potential for actual harm assessments and plan of care. The resident has the right to make choices about aspects of his life Residents Affected - Few in the facility that are significant to the resident, including the right to exercise free choice in selecting activities, schedules and daily routines. The resident has the right to interact with member of the community and participate in community activities both inside and outside the facility. The resident has the right to receive visitors of his choosing and the time of his choosing. The facility must provide immediate access to a resident by immediate family and other relatives of the resident. The facility must provide immediate access to a resident by others who are visiting with the consent of the resident. The resident has a right to participate in resident groups in the facility. The resident has the right to participate in activities, including social, religious and community activities. G. Information and Communication: The resident has the right to have reasonable access to the use of a telephone, including the right to retain and use a cellular phone at the residents own expense. The facility must protect and facilitate 145863 Page 4 of 8 145863 07/09/2025 Integrity Hc of Marion 1301 East Deyoung Marion, IL 62959

F 0550 the resident's right to communicate with Level of Harm - Minimal harm or potential for actual harm individuals and entities within and external to the facility. Residents Affected - Few I. Personal Property: The resident has the right to retain and use or wear personal property in the resident's Attachment I: Inventory Log is left blank and indicates R1 was admitted without any personal property. A hand written N/A (not applicable) is noted on top of the page. R1's facility admission contract on page 14 and titled Signature Page, contains the written signature of R1 and documented the signature was obtained on 6/19/2025. The contract does not include any information that restricts R1's rights as a resident being admitted to this facility and does not include any information or agreement with the federal prison system for restricting R1's rights as a resident of this facility. On 7/8/2025 at 10:00am, V1 (Administrator) said R1 was admitted to this facility on 6/18/2025. V1 said R1 was admitted for a short term stay to receive IV (intravenous) antibiotics and then will be discharged . V1 said R1 is an inmate of the federal prison system and has two federal prison guards watching him in his room. V1 said 145863 Page 5 of 8 145863 07/09/2025 Integrity Hc of Marion 1301 East Deyoung Marion, IL 62959

F 0550 because R1 is a federal prisoner, R1 is not Level of Harm - Minimal harm or potential for actual harm allowed to leave his room, not allowed to leave the facility, not allowed to participate in facility Residents Affected - Few activities, is not allowed to have personal property, is not allowed to have visitors and is not allowed to use the telephone. V1 said the facility must follow the rules the federal prison imposes on R1 due to R1 being a prisoner. V1 said the facility does not have any policies or protocols on admitting inmates for medical care to this facility. V1 said the facility does not have any type of contract with the federal prison system for providing care for federal inmates. V1 said the facility treats R1 like any other resident, and R1 signed the facility admission contract himself. V1 said the facility has in the past admitted other federal prisoners for short term medical care that did not require being shackled to their beds, they could participate in facility activities, leave their room, could eat in the dining room and they did not require being guarded by prison guards. On 7/8/2025 at 1:45pm, V4 (Registered Nurse) said he is the nurse providing care for R1. V4 said R1 is in a private room with a private bathroom with two armed prison guards 145863 Page 6 of 8 145863 07/09/2025 Integrity Hc of Marion 1301 East Deyoung Marion, IL 62959

F 0550 monitoring R1 in R1's room. V4 said R1 is Level of Harm - Minimal harm or potential for actual harm chained to the bed and is not allowed to leave the room. V4 said R1 eats all his meals in his room Residents Affected - Few and is not allowed to use the call light. V4 said R1 provides his own activities of daily living care and does not require staffs assistance for toileting or bathing. On 7/9/2025 at 10:30am, R1 was observed in his room, in bed and was handcuffed to his bed. Two guards were sitting in R1's room guarding him. R1 was dressed in a hospital gown. R1 had no personal belongings in his room. R1 said he has not been allowed to leave his room since being admitted to this facility on 6/18/2025. R1 said he has not been allowed any visitors or use a telephone since being admitted to this facility. R1 said he is not allowed to have any personal property or wear any personal clothing since being admitted to this facility. On 7/9/2025 at 11:45am, V8 (Federal Prison Captain) said R1 is an inmate of the federal prison system and R1 is only at this facility for short term medical care and then will be discharged back to the federal prison. V8 said the federal prison has protocols they must follow for 145863 Page 7 of 8 145863 07/09/2025 Integrity Hc of Marion 1301 East Deyoung Marion, IL 62959

F 0550 inmates who are outside of the prison and have Level of Harm - Minimal harm or potential for actual harm been admitted to healthcare facilities for medical treatment. V8 said due to R1's criminal Residents Affected - Few convictions, the federal prison's protocols require R1 to be handcuffed to his bed at all times and have two guards watching him. V8 said if deemed medically necessary, R1 would be allowed to leave his room, but R1 must be fully shackled with leg irons, hand cuffs, monitoring devices and be in the presence of two armed prison guards. V8 said R1 is not allowed to participate in any activities inside or outside of the facility and is not allowed access to a telephone or visitors. V8 said he could not provide the surveyor with a copy of the federal prisons protocols for R1 without permission from their legal department. V8 said he did not have permission to release the protocols and thus would not. 145863 Page 8 of 8