Inspection·July 2, 2025

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 4. On 7/2/25 at 9:30 AM R4 stated, The CNAs say they don't have any large diapers. They are given 5 large diapers per shift and they run out. I can change my own pull up so I use 1-2 of those a day and 6-8 diapers a day. This has been going on for a while. They say they are locked up in the supply room but then when the CNAs try to get them they say there aren't any. This happens on and off but for the past few months. They have some and then they don't. On 7/2/25 at 9:35 AM R5 stated, They do not have the large pullups- they keep bringing in the XL and they are too big. The CNAs say they do not have any. This is from last week. I go though 1-2 pull ups per day and 2-4 diapers. I can't understand how they can not have any! On 7/2/25 at 9:45 AM R7 stated, Staff tell me they don't have any. I need a size 3XL. This has happened quite often recently. I just got back from the hospital and I went about 3 days without any. They have the 2 XL and they have to double them up because they are not big enough and I take a water pill and I go a lot. On 7/2/25 at 1:10 PM R9 stated, I have talked to (V1- Administrator) directly and she has assured me that the diapers are here. I want the white ones. The green ones are a 2 x and they are too small - I need the 3 X. Over the weekend the nurse and the CNA said they are not here. (V1) told me maybe the CNAs are using the wrong sizes on residents and that is why they are running out. I have been here 9 months and this has happened every weekend to someone in this building- not always to me but this is about the 3rd time in the last 3 months. (V7- Central Supply) is always walking around here with diapers but then they say we don't have any. This past Sunday they said they looked in the storage area and they could not find them. (V1) said they are on site but maybe the CNAs are stashing the diapers. R4's Minimum Data Set (MDS) dated [DATE] shows she has no cognitive impairment. R5's MDS dated [DATE] shows she has no cognitive impairment. R7's MDS dated [DATE] shows she has no cognitive impairment. R9's MDS dated [DATE] shows he has no cognitive impairment. On 7/2/25 at 9:40 AM V5 stated, We have a problem with diapers. I have 12 residents and 3 of them are independent and do not use the diapers. They used to be in a storage room downstairs but now they are in the HR office and we can not get to them. They send 2 CNAs down in the morning to get a cart (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: 145936 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 145936 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/02/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Aliya of Highwood 50 Pleasant Avenue Highwood, IL 60040 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)