Health inspection·April 7, 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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to ensure two residents (R7, R10) of five reviewed remained free from abuse in a total sample of 14. This failure resulted in R7 and R10 physically abusing each other. Findings include: R7's current face sheet documents R7's medical diagnosis to include but not limited to schizophrenia, unspecified, chronic obstructive pulmonary disease with (acute) exacerbation, schizoaffective disorder, unspecified, major depressive disorder, recurrent, unspecified, generalized anxiety disorder, gastro-esophageal reflux disease without esophagitis, epilepsy, unspecified, not intractable, without status epilepticus, delusional disorders. R7's MDS (Minimum Data Set) section C dated [DATE], documents R7's Brief Interview for Mental Status (BIMS) as 15/15 indicating R7 has intact cognitive function. On 04/03/2025, at 11:47 AM, R7 was observed in his room sitting on his bed and was observed to be paranoid. R7 stated he does not have mental health issues and he should not be in this facility. R7 stated on 4/1/2025, R10 was roaming on the units and entering residents' rooms. R10 went to R7's room and was stealing R7's food which included crackers that were on top of R7's bedside drawer. R7 pointed where he had kept his food items. R7 stated R10 hit him on the head when he (R7) asked him (R10) to stop taking his food without permission. R7 stated, All bets were off, and he defended himself. R7 started punching R10 on the head and after punching R10 several times, R7 controlled himself and left his room because he did not want to hurt R10 anymore because they used to be friends. R7 stated there were no staff near to witness or monitor residents who wonder and enter other residents' rooms at that time. R7 stated he told staff what had happened. R7 then went back to his room and punched the TV with his right hand because he was so upset that staff did not prevent R10 from going into his room and eating/stealing his food. R7 was observed with several small cuts on the back his right fist which were healing and stated he sustained them after punching the TV; staff did not do anything about it. R7 stated he does not feel safe at the facility because staff do not round the units and there is no security on each floor, but he can defend himself. R7 stated he wanted to be discharged because he does not have a mental health issue to be living in the facility. R10 current face sheet documents R10's medical diagnosis to include but not limited to: schizoaffective disorder, unspecified, bipolar disorder, unspecified, major depressive disorder, single episode, unspecified, and insomnia due to medical condition. R10's MDS (Minimum Data Set) section C (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 3 Event ID: 145864 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 145864 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Bria of Forest Edge 8001 South Western Avenue Chicago, IL 60620 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)