Inspection·February 26, 2025

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observation, interview, and record review the facility failed to ensure medications were not left at bedside for one (R2) resident and failed to ensure a treatment cart was locked when not in visual proximity of the nurse and not in use. This failure has the potential to affect all 36-residents residing on the 4th floor of the facility. Findings include: 1. On 02/24/25 at approximately 11:12am, R2 noted in bed, on the cabinet in the room a bottle of Fluocinonide topical solution with instruction to apply to scalp topically@ bedtime with a pharmacy label to Avoid contact with eyes. In addition, a tube of Econazole nitrate cream 1% left on the table. When V4 ADON (Assistant Director of Nurse's) was shown and was asked about the facility policy/protocol on medication storage at the bedside. V4 stated no medicine should be left at bedside without an order (referring to physician order) but let me check if there is an order to leave at the bedside. V4 then took the medications to V5 RN (Registered Nurse) assigned to R2. Both V4, V5 and the surveyor checked the EPO (Electronic Physician Order) for R2 there was no written order for R2 to keep those medication at the bedside or self-administer the medication. V5 asked the surveyor whether topical medications can be kept at bedside. The surveyor asks V5 about the professional standard of medication storage/ administration. V5 stated I don't know, can we move to the next question. V4 who was present at the time stated, I will have to educate the nurses on medication storage when there is no order (Physician Order) to do so. On 02/24/25 at 11:58am V2 DON (Director of Nurse's) stated that all medication should be locked in the medication cart unless the physician ordered it to be kept at bedside. The facility policy and professional standard of medication administration is that any medication should be prescribed by the doctor (physician). Any one on elf-administration program will be evaluated and see if they are able to self-administer the medication. 2. On 02/24/25 at 10:57am, on the 4th floor upon getting on the floor treatment cart with treatment medications noted unlocked with no licensed nurse or any staff at the nurse's station. When this was shown to V5 RN (Registered Nurse) and was asked about the facility policy on medication storage and cart policy. V5 stated it is not my cart, but the treatment cart should always be locked when not in use. (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: 145974 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 145974 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Norwood Crossing 6016 North Nina Avenue Chicago, IL 60631 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)