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** Based on
observation, interview, and record review, the facility failed to follow the medical patient rights act which
requires staff members to wear a visible name badge that discloses the employee's first name, licensure
status, if any, and staff position of the person examining or treating the patient or resident. This has the
potential to affect all 43 residents residing on Unit 1 at the facility.Findings include:Facility census dated
11/14/2025 documents 43 residents residing on Unit 1 at the facility.R1's face sheet documents diagnoses
that include but are not limited to depression, acute kidney failure, type 2 diabetes, and chronic obstructive
pulmonary disease.R1's Minimum Data Set (MDS), dated [DATE], documents, in part, a Brief Interview of
Mental Status (BIMS) score of 15 which indicates that R1 is cognitively intact.On 11/14/2025 at 12:27pm,
R1 said, No, there are very few staff that wear ID badges. It's a problem. I (R1) didn't even know who the
guy was trying to get me to sign consents. I (R1) want to know who I (R1) am talking to and who is caring
for me. How do I (R1) know if it's not just someone off the street. Am I (R1) just supposed to believe the
person coming in my room that they are staff here? I (R1) don't want to be taken advantage of.R3's face
sheet documents diagnoses that include but are not limited to asthma, diabetes and congestive heart
failure.R3's Minimum Data Set (MDS), dated [DATE], documents, in part, a Brief Interview of Mental Status
(BIMS) score of 15 which indicates that R3 is cognitively intact.On 11/14/2025 at 12:33pm, R3 said, That's
a joke. The staff hardly ever have ID badges on. Sometimes, they (staff) slap a sticker on their shirt with
their name. I (R3) know most of them though. When there's a new face, I'm (R3) like who is this? Don't
touch me if you can't prove who you are. It would be nice if they (staff) wore badges.R4's face sheet
documents diagnoses that include but are not limited to diabetes, chronic kidney disease, and anxiety
disorder.R4's Minimum Data Set (MDS), dated [DATE], documents, in part, a Brief Interview of Mental
Status (BIMS) score of 15 which indicates that R4 is cognitively intact.On 11/14/2025 at 12:38pm, R4 said,
No, most staff don't wear ID badges. I (R4) know most of them (staff). The staff is good. I (R4) don't want to
get any of them in trouble.On 11/14/2025 at 11:12am, during tour of the facility with V2 (Director of
Nursing/DON), V3 (Licensed Practical Nurse/LPN) was observed with an ID badge that was not visibly
displaying V3's name and staff position. V3 said, Oh, it's here. Let me fix it. V2 proceeded to take apart V3's
ID badge so V3's name and staff position was visible.On 11/14/2025 at 11:15am, during tour of the facility
with V2 (Director of Nursing/DON), V4 (Certified Nursing Assistant/CNA) was observed without an ID
badge, V4 said, It's (ID badge) getting made. I (V4) lost it about a week ago.On 11/14/2025 at 11:26am,
during tour of the facility with V2 (Director of Nursing/DON), V6 (Restorative Aide) was observed without an
ID badge. V6 said, I've (V6) never had a real badge. I've (V6) been here like a year.On 11/14/25 at
11:28am, during tour of the facility with V2 (Director of Nursing/DON), V5 (Certified Nursing Assistant/CNA)
was observed without an ID badge. V5 said, I (V5) wasn't given a badge. Been here about 3
months.Facility's daily
(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 2
Event ID:
145947
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
145947
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
11/15/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Aperion Care Midlothian
3249 West 147th Street
Midlothian, IL 60445
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)
F 0550
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
schedule, dated 11/14/2025, documents the follow: V3 (Licensed Practical Nurse/LPN) assigned to Unit 1;
V4 (Certified Nursing Assistant/CNA) assigned to Unit 1; V6 (Restorative Aide) assigned to Unit 1; and V5
(Certified Nursing Assistant/CNA) assigned to Unit 1.V2's (Director of Nursing/DON) e-mail, dated
1/14/2025 at 2:50pm, documents the hire dates for the following employees: V3 (Licensed Practical
Nurse/LPN) hire date of 11/3/2025; V4 (Certified Nursing Assistant/CNA) hire date of 12/2/2024; V5
(Certified Nursing Assistant/CNA) hire date 7/31/2025; and V6 (Restorative Aide) hire date 1/11/2024. On
11/14/2025 at 11:30am, V9 (RN/Registered Nurse/Regional [NAME] President of Operations) said that it's
preferred for staff to wear ID badges. V9 stated that it doesn't take a minute to obtain the employees' ID
badges. V9 said that V9 is unaware if there is a policy on employees wearing ID badges, but V9 will check
to see if there is a policy.On 11/14/2025 at 2:53pm, V2 (Director of Nursing/DON) said I (V2) was told there
is no policy for employee ID badges. No one could find it. I (V2) know that the students that come here have
ID badges. All employees should have ID badges so the residents can identify who is caring for them. We
(facility) do have different colored scrubs to differentiate between different job positions. V2 stated that the
facility has stickers to put the required information on if an employee does not have a badge. V2 affirmed
that employees should wear ID badges when working.Record review of The Public Health (410 ILCS 50/)
Medical Patient Rights Act, Sec. 6. Identification badges, documents, in part, A health care facility that
provides treatment or care to a patient in this State shall require each employee of or volunteer for the
facility, including a student, who examines or treats a patient or resident of the facility to wear an
identification badge that readily discloses the first name, licensure status, if any, and staff position of the
person examining or treating the patient or resident. (Source: P.A. 98-243, eff. 1-1-14; 98-890, eff. 1-1-15;
99-180, eff. 7-29-15.)Record review of the Illinois Long-Term Care Ombudsman Program Residents' Rights
for People in Long-Term Care Facilities, revised date 11/18, documents, in part, . Your facility must provide
services to keep your physical and mental health, at their highest practical levels. Your facility must be safe,
clean, comfortable, and homelike.
Event ID:
Facility ID:
145947
If continuation sheet
Page 2 of 2