Inspection·April 25, 2025

F 0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Level of Harm - Actual harm Residents Affected - Few **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to prevent and protect one resident (R1) from resident-to-resident abuse out of four residents reviewed for physical assault. This failure resulted in R1 sustaining a fracture of the left ankle in a total sample of four residents. Findings include: On 04/22/2025, at 11:57 AM, R1 states the altercation between himself and R2 began when he refused to lend his Bluetooth speaker to another female resident. R1 states all parties were located on the first floor of the facility during this time. R1 states R2 inserted himself into the situation and began to try to impress the female resident. R1 states R2 then began calling R1 bit**es and saying he will catch R1 outside. R1 states he and R2 then started a verbal argument and that's when R1 decided to remove himself from the situation. R1 states he began to self-propel himself in the opposite direction from R2. R1 states when he turned his back, R2 rammed him really hard with R2's electric wheelchair, knocked R1 onto the floor, and ran over R1's leg. R1 states R2 then reversed his wheelchair and proceeded to run him over again but that's when staff intervened and stopped R2 from doing so. R1 states staff separated them and R1 went back to his room. R1 states the staff only asked him if he was okay and R1 said yes at the time. R1 states the staff was in the process of trying to change his room when he began feeling pain later. R1 states when staff initially asked was he okay, R1 did not feel any pain. It could have been due to his adrenaline. R1 states he does not know the nurse's name, but he informed the female nurse on duty that he believed something was wrong. R1 states he informed the nurse that he may have broken his foot and that he was now in pain. R1 states staff did not assess him or take his vital signs. Staff moved him to another room located on the second floor. R1 states shortly after being moved to the second floor, he attempted to go to the restroom. R1 states he then felt more pain in his foot as he tried to use the restroom and that's when he fell. R1 states he fell in the restroom due to the pain he felt in his foot. R1 states he then told staff again that his foot was in pain, and he needed to go to the emergency room. R1 states he now has an appointment scheduled on 04/24/2025, with an orthopedic surgeon to have plates and screws placed in his foot. R1 states there have been no consequences for R2 and R2 continues to get community pass privileges. R1 states R2 can also come to the floor where R1 now resides anytime R2 feels like it. On 04/22/2025, at 12:27 PM, R4 states he did not witness the altercation that took place between R1 and R2. R4 states he has witnessed on multiple occasions how R2 is aggressive towards people. R4 states a couple of days ago, while on the smoking patio, R2 was bragging about how he ran over R1's foot and R2 stated to R4 that R2 would do it again. R4 states he also witnessed R2 roll up to R1 and kick R1's Bluetooth speaker onto the floor. R4 states R2 resides on the first floor of the facility but R2 continuously comes to the second floor where R1 is located just to bother R1. R4 states R2 (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: 145914 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 145914 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/25/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Southpoint Nursing & Rehab Center 1010 West 95th Street Chicago, IL 60643 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)