Health inspection·December 19, 2025

F 0583 Keep residents' personal and medical records private and confidential. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to provide privacy during blood glucose monitoring and insulin injections. This deficiency affects one (R60) of two residents in the sample of 16 reviewed for privacy during Medication Administration.Findings include: On 12/16/25 at 11:05AM, Observed V7 LPN (Licensed Practical Nurse) performed peripheral blood glucose/sugar monitoring to R60 in the hallway by the nursing station where visible to other residents and staff members. Then V7 prepared Humalog lispro 5 units and administered to R60's abdominal area subcutaneously. V7 said that R60 prefers to monitor his blood sugar and receive his insulin in the hallway without privacy.On 12/16/25 at 11:10AM, Reviewed R60's comprehensive care plan with V8 Charge Nurse. No care plan addressing R60's preference of monitoring his blood glucose/sugar and receiving insulin in the hallway without privacy. V8 said that R60's preference of having no privacy during monitoring of blood sugar and administration of insulin without privacy should be addressed in care plan.On 12/16/25 at 11:17AM, Informed V9 Resident Coordinator of above observations and concerns. V9 said that she is not aware that R60 prefers to monitor his blood sugar and receives insulin injection in the hallway without privacy. V9 said that his preference should be reflected in his comprehensive care plan.R60 is admitted on [DATE] with diagnosis listed in part but not limited to Hemiplegia and hemiparesis following cerebrovascular disease affecting left non-dominant side, Type 2 Diabetes Mellitus, Chronic Kidney disease. Active physician order sheet indicated: Blood glucose monitoring AC and HS call physician for results less than 70 or greater than 300 before meals and at bedtime. Humalog Kwik pen subcutaneous (SC) solution pen injector 100 unit/ml (Insulin Lispro) inject 5 units SC with meals. Lantus solo star subcutaneous solution pen injector 100 unit /ml (Insulin Glargine) inject 8 unit subcutaneous in the morning. Comprehensive care plan revised by V9 resident coordinator after surveyor discussed concern with her dated 12/16/25 indicated: R60 prefers his blood check and insulin shot if applicable to be done in the hallway or dining area.Facility's policy on Medication Pass Guidelines 04/19 indicated: 6. Privacy*While privacy is always a priority, it is required for the following procedures: -Injections-Blood glucose monitoring.Facility's policy on Comprehensive Care plan 11/2027 indicated:An individualized, person-centered comprehensive care plan, including measurable objectives with timetables to meet resident's physical, psychosocial and functional needs is developed and implemented to each resident. Procedure: 1. In coordination with the resident and resident representative, as applicable, the interdisciplinary team will develop and implement a person centered, comprehensive plan of care. Care plans are comprised of focus statements, goals, and interventions. 8. Assessment of the resident is ongoing and care plans are revised based on the resident condition, preferences, treatments, and goal change. Residents Affected - Few 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 4 Event ID: 145907 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 145907 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/19/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Alden Estates of Evanston 2520 Gross Point Road Evanston, IL 60201 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)