Health inspection·December 6, 2025

F 0689 Level of Harm - Actual harm Residents Affected - Few eventually was let go of the facility due to multiple factors. The Fall Risk assessment dated [DATE] documents At risk for falls. GG Screener assessment dated [DATE] documents Toileting Hygiene: Dependent transfer. Functional Abilities- admission assessment dated [DATE] documents Chair/bed to chair transfer: Dependent transfer. Toilet transfer: dependent transfer.Restorative Progress note dated 11/21/25 documents staff/patient education to use walker with 2-person assist to transfer using left side/good side for safety. Radiology Progress Note dated 11/25/25 documents Patient X-ray result was with hip dislocated.Physical Therapy Evaluation and Plan of Treatment dated 11/20/25 documents R1 is a Max assist out of bed and total dependence assist with transfers. The Care Plan dated 11/19/25 documents R1 is at high risk for falls d/t generalized muscle weakness, impaired mobility, gait, balance, decreased activity tolerance and medical diagnosis of right pre-prosthetic hip, myelodysplastic syndrome. Interventions in place include encourage appropriate use of walker, bed to chair transfer 2-person assist using rollator walker using good side/left side to transfer. The Care Plan dated 11/21/25 documents R1 has an ADL functional performance deficit due to generalized muscle weakness, impaired mobility, gait, balance, decreased activity tolerance and medical diagnosis of right pre-prosthetic hip, myelodysplastic syndrome. Interventions in place include bed to chair transfer 2-person assist using rollator walker using good side, left side to transfer. Facility Policy on Transfer revision date 2/10/2022Definition: Transfer refers to activities provided to improve or maintain the resident's self-performance in moving between surfaces or planes either with or without assistive devices. These activities are individualized to the resident's needs, planned, monitored, evaluated, and documented in the resident's medical record. Considerations:2. Fractures- Follow physician orders regarding movement or weight bearing restrictions and any therapy recommendations when developing individualized programs. General transfer guidelines:1. Resident safety, dignity, comfort and medical condition will be incorporated into goals and decisions regarding the safe transfers of residents. 2. Manual lifting of resident's should be eliminated when feasible. 3. Nursing staff, in conjunction with the rehabilitation staff, shall assess individual resident's needs for transfer assistance on an ongoing basis. Staff will document resident transferring and lifting needs in the care plan. Such assessment shall include:a. Resident's preferences for assistance. b. Resident's mobility (degree of dependency)c. Residents sized. Weight-bearing abilitye. Cognitive statusf. Whether the resident is usually cooperative with staff g. The resident's goals for rehabilitation, including restoring or maintaining functional abilities. 4. Staff responsible for direct resident care will be trained in the use of manual (gait/transfer belts, lateral boards) and mechanical lifting devices. General Transfer Procedures:3. utilize assistive devices as needed: bedrails, walker, slide board, etc.7. transfer toward the resident stronger side and place the chair/wheelchair at the resident's stronger side when possible. Facility Policy on Management of Falls revision date 8/2020Policy: The facility will assess hazards and risks, develop a plan of care to address hazards and risks, implement appropriate resident interventions, and revise the residents plan of care in order to minimize the risks for fall incidents and/or injuries to the resident. Procedure:1. Complete a Fall Risk Assessment upon admission, re-admission, with significant change, post-fall, quarterly, and annually. 3.Develop a plan of care to include goals and interventions which address resident's risk factors. Risk factors may include but are not limited to the following contributing diagnosis/disorders/diseases processes/ active infections/ other comorbidities, history of fall incidents, incontinence, medications (Narcotics, Antihypertensives, etc.), assistance required with ADL's, gait/transfer/balance issues, Behaviors, and /or cognitive status. 4. provide assistive devices for mobility, hearing and vision as appropriate for the resident. 5. Assess appropriateness for resident to participate in skilled therapy or (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145998 If continuation sheet Page 2 of 3 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 145998 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/06/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Alden Des Plaines Rehab & Hc 1221 East Golf Road Des Plaines, IL 60016 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 0689 restorative programming in order to maintain or improve physical function or resident. Level of Harm - Actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 145998 If continuation sheet Page 3 of 3