Health inspection·June 13, 2023

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm Based on interview and record review the facility failed to implement timely treatment for a Urinary Tract Infection (UTI). This applies to 1 of 3 residents (R1) reviewed for Urinary Tract Infections in a sample of 11. Residents Affected - Few Findings include: R1's admission Record dated 6/12/2023 documents diagnoses to include UTI (4/6/2023) and Urine Retention. R1's Progress Notes dated 4/5/2023 documents R1 re-admitted from the hospital with diagnoses to include UTI with orders for Antibiotics to continue after re-admission. R1's Progress Notes dated 4/28/2023 documents R1 with confusion; V6 (Nurse Practitioner) was notified and ordered a Urinalysis and Urine Culture. R1's Lab Results Report documents R1's Urine sample was collected for testing on 4/28/2023 with a final result reported on 5/1/2023. The Urine Culture report documents R1 with 70-90,0000 Extended Spectrum Beta Lactamase Resistant organisms (ESBL). R1's Progress Notes on 5/1/2023 document V20 (Physician) was contacted regarding R1's Urinalysis and Urine Culture report and ordered the Infectious Disease practitioner be consulted. This note further documents the result was faxed to the Infectious Disease office. R1's Progress Notes on 5/2/2023 document the facility is waiting for a response from the Infectious Disease office and R1 continues on contact isolation due to ESBL infection in her Urine. On 6/12/2023 at 10:55 AM V7 (Infection Preventionist) stated the results of the Urine Culture and Urinalysis report were faxed to the Infectious Disease office on 5/1/2023 and on 5/2/2023 V7 communicated with a Registered Nurse in this office to provide a history of R1's recent infections and Antibiotic use. V7 stated she reported R1 had no condition changes so R1 was placed on V19's (Infectious Disease Nurse Practitioner) list for rounding on 5/3/2023. V7 stated she was unaware of R1's condition changes, including confusion, as documented in R1's nurse progress notes. R1's Progress Note dated 5/3/2023, completed by V19, documents R1 was evaluated for a positive Urine Culture showing ESBL. This note documents R1 with increased confusion, with tenderness to deep abdominal palpation, and pus in her urine. V19 ordered initiation of an Intravenous Antibiotic which started on 5/3/2023. Page 1 of 2 145892 145892 06/13/2023 Sunny Hill Nursing Home of Will County 421 Doris Avenue Joliet, IL 60433

F 0684 Level of Harm - Minimal harm or potential for actual harm On 6/9/2023 at 1:07 PM V5 (Nurse) stated when a positive Urine Culture is resulted the primary Physician or Nurse Practitioner are notified who sometimes refer to the Infectious Disease office. V5 stated if she needs to notify the Infectious Disease practitioners of an abnormal Urine Culture, she notifies them via phone promptly and will continue to make notifications until they are reached for further direction. Residents Affected - Few R1's Brief Interview of Mental Status on 4/12/2023 documents R1 as cognitively intact. On 6/12/2023 at 9:07 AM V19 stated the facility usually will call her or the office to get orders and to report abnormal Urinalysis/Culture results. V19 confirmed good practice is to make timely notification to the Physician or herself for all positive Urine Cultures to determine a treatment plan, especially because she was symptomatic. 145892 Page 2 of 2