Health inspection·January 15, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Based on observation, interview and record review, the facility failed to replace a broken domestic water heater that provide hot water to resident's bathroom sinks and shower room. This affected eight of eight residents (R3-R6, R8-R11) reviewed for hot water and homelike conditions. Finding Includes: On 1/9/25 at 10:50am, V3 (maintenance director) said, We had an issues with the hot water for a few days. We have two hot water tanks that supply domestic water/ water to the resident's room and the three compartment sink in the kitchen. One of the two water tanks is broken. The other functioning water tank is having a work load stain. On 1/9/25 at 10:54am, V3 tested the water temperature from R8's - R11's bathroom sink after letting it run for 20- 30 seconds the water temped at 77 degrees F for all the sinks. R8-R11's bathroom sink water was cold to touch. R9 who was assessed to be alert and oriented to person, place and time, said her water has been cold for a while. R9 was informed the pilot light went out on the water heater. V3 said the water temperature should be 105 degree F to 115 degree F. On 1/9/25 at 1:23pm, R3 who was assessed to be alert and orient to person, place and time, said the water was cold this morning. R3 said the water was allowed to run but it was barely warm. R3 said he was given a wash basin, washed his face and upper body. R3 said the water was cold within minutes. R3 said when staff washed his back, the water was cold. R3 said he has refused to shower because the water is too cold, and he doesn't want to get sick. R3 said as much money as his insurance has to pay, the care/services should be better. V3 tested the water temperature from R3/R4's bathroom sink after letting it run for 20- 30 seconds. The water temped at 77 degrees F. R3/R4's sink water was cold to touch. On 1/9/24 at 1:34pm, R4 who was assessed to be alert and orient to person, place and time, said he has to bathe with cold water to get ready for dialysis this morning. On 1/9/25 at 1:42pm, R5 who was assessed to be alert and orient to person, place and time said there isn't any hot water. R5 said he has not had a shower in a week. R5 said he was told the hot water tank went out. R5 said he feels grimy because he has not showered. On 1/9/25 at 1:47pm, R6 who was assessed to be alert and orient to person, place and time said her water has been cold and she has not had a shower since Christmas. On 1/9/25 at 2:01pm, V11 (heating/air condition personnel) said, We were at the facility on Friday Page 1 of 2 145927 145927 01/15/2025 Prairie Oasis 16000 South Wabash South Holland, IL 60473

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 1/3/25. One of the boiler (water heater) wasn't working. The facility needs a water heater. We don't have an estimate date of delivery for a new water heater. Nothing is in stock. One water heater is not enough to supply hot water to the whole building. On 1/10/25 at 11:21am, V3 tested the hot water of all four shower stalls on 300 unit. Two shower temped at 80 F and the other two temped at 82F. V3 tested the water of all three shower stalls on the 200 unit. One shower temped at 79 F and the other two temped at 80F. The tub was not operational on the 200 unit. The water in all of the common shower room was cold to touch. V3 said, the water temperature should be 105 degree F to 115 degree F. On 1/10/25 at 11:34am, V3 tested the water of all four shower stalls on 100 unit. All the showers temped at 79 F. The water in all the common shower room was cold to touch. On 1/15/25 at 8:34amm V3 said he used a water thermometer which was already calibrated. V3 said the thermometer was place in cold water which was reset to zero. Heating and Air conditioning invoice dated 1/3/25 documents: Called out after hours for no domestic hot water. Upon arrival, talked with (V3). Currently, boiler one has a cracked heat exchanger and is leaking. Temperatures were very low last night and the one boiler with one storage tank for the whole building cannot keep up. We relayed to the maintenance and [V1 (administrator)] that the boiler needs to be replace. We are currently working on finding a boiler in stock locally and working up the estimate. Heating and Air conditioning invoice dated 1/9/25 documents: RE: Domestic Boiler #1 replacement 2025 update. Due to the fact that this boiler#1 is out of commission due to leaking and major issues with the old boiler, the boiler needs to be replaced. We will remove the existing faulty and compromised domestic hot water boiler from jobsite. We will then set in place a new 2-stage 85% efficient domestic water heating 400, 000 BTU boiler and provide all necessary modifications and connections to the flute, gas, electric and water piping in order to put new boiler into proper operating conditions. Note: Currently one boiler in local stock. Once gone from stock it will be 4-6 weeks. Install price $17,450.00. TELS master paperwork documents each stated will have its own regulation on maximum water temperature allowed, but it typically will fall between 105 to 115 degrees F. Control Measure: Hot Water System: Risk Factor: Water Heater: Monitoring: Ensure Temperature is at a minimum of 122F (50C) Control limits (lower) 122F (50C). Control Limits (upper) 140F (60C) Domestic water policy undated documents did not apply. 145927 Page 2 of 2