Inspection·June 26, 2025

F 0806 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. Based on interview and record review the facility failed to accommodate residents' food preferences and choices for 4 of 6 residents (R2, R3, R5, R6) reviewed for residents' food preferences and choices in the sample of 6. The findings include: The facility's daily menus dated 6/11/25-6/24/25 showed primarily cold foods and/or room-temp foods, such as cold cereal, canned fruit, deli meat sandwiches, potato chips, salads, ice cream, and pudding, were listed as the available food items on the menus. A limited selection of hot foods were listed as menu choices which included scrambled eggs, oatmeal, hamburgers, mashed potatoes, and grilled cheese sandwiches. The menus showed, Due to complication in the kitchen we will be in emergency mode until further notice we do apologize for the inconvenience. On 6/26/25 at 8:59 AM, V3 (Registered Dietician) stated on 6/11/25, the facility began serving primarily cold foods, including sandwiches, salads, and fruit to residents at meals because the dumbwaiter (elevator that carries food from the kitchen to the facility's dining room) had broken. V3 stated the facility was concerned about the safety of their kitchen staff if they required the kitchen staff to carry hot meals/dishes up the stairs from the kitchen to the facility's dining room, while the dumbwaiter was broken. V3 stated that due to this potential safety concern for their kitchen staff, they initiated an emergency cold food plan to serve primarily cold foods to the residents until the dumbwaiter was fixed. However, due to resident complaints related to the cold food menu/service, the facility resumed their regular hot food menu on 6/25/25. V3 stated, The dumbwaiter is still broken but we went back to serving hot foods yesterday because so many residents complained about the cold food. People said they were tired of getting bread and sandwiches. I was here when the dumbwaiter went down and did approve the emergency cold food menus. We did offer some hot foods during that time such as oatmeal and instant mashed potatoes . On 6/26/25 at 8:48 AM. R2 was asked about the foods served to her last week in the facility. R2 stated, I ate a lot of turkey sandwiches, tuna, and chicken salad. They said no hot foods because a lift was down. That's not what I wanted to eat. Last Friday night, I was served 10 pieces of watermelon, cottage cheese, and pudding. I couldn't eat that. I sent my boyfriend to go get me food. On 6/26/25 at 8:40 AM, R3 stated last week he was served all cold foods. R3 stated, I ate what they brought but it was mostly sandwiches. We kept getting the same foods over and over. I understand getting cold foods for a couple of days, but it went on far too long. A couple of days ago, I said I wasn't going to eat that stuff anymore. I had my son bring me food. On 6/26/25 at 8:26 AM, R5 stated they told us the waiter was down and they couldn't bring up hot foods from the kitchen. R5 stated, I'm a meat and potatoes guy. A couple of days of sandwiches I can understand but not a whole week. On 6/26/25 at 11:44 AM, R6 was asked about the foods served to him last week in the facility. R6 stated, I couldn't eat anymore sandwiches or oatmeal. Every day it was a sandwich for lunch and dinner. One night they tried to serve me a tray of fruit and cottage cheese. I prefer hot foods for at least one meal. I spent most of the week having food brought in by my daughter or ordering out. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146069 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 146069 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/26/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE East Bank Center, LLC 6131 Park Ridge Road Loves Park, IL 61111 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 0806 Level of Harm - Minimal harm or potential for actual harm A facility Complaint/Grievance Report dated 6/24/25 showed a complaint from R3 and his family in regard to foods served while the facility's emergency cold food plan was in place. The facility's Therapeutic Diets Client's Right to Choose policy (dated 2021) showed, Client's right to be served food they choose and prefer will be honored. Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146069 If continuation sheet Page 3 of 3