Inspection·March 18, 2025

F 0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Level of Harm - Actual harm Residents Affected - Few Based on observation, interview, and record review the facility failed to prevent resident to resident physical abuse by a known perpetrator for two (R22 and R23) of 13 residents reviewed for abuse in the sample of 36. This failure resulted in R22 hitting R23 in the mouth which caused R23 to suffer bleeding from her mouth. Findings include: The facility Abuse, Prevention, and Prohibition policy and procedure, dated 12/2024, documents Each resident has the right to be free from abuse, corporal punishment, and involuntary seclusion. Residents must not be subjected to abuse by anyone, including, but not limited to facility staff, other residents, consultants, or volunteers, staff of other agencies serving the resident, family members or legal guardians, friends, or other individuals. Abuse - means the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish and means the individual must have acted deliberately, not that the individual must have intended to inflict, injury or harm. An example of a deliberate (willful) action would be a cognitively impaired resident who strikes out at a resident within his/her reach, as opposed to a resident with a neurological disease who has involuntary movements (e.g., muscle spasms, twitching, jerking, writhing movements) and his/her body movements impact a resident who is nearby. This policy also documents that all instances of abuse, even those residents in a coma, can cause physical harm, pain, or mental anguish. The Final Report to the State Agency, dated 1/1/2025, documents, Original Complaint: It was reported to the abuse coordinator on 12/27/24 of an alleged physical altercation. While in the dining room (R22) allegedly struck (R23). The Account of events documents R22 and R23 were sitting in the dining room, R23 put her hand on R22's shoulder and began shouting. (R22) appeared to be startled, stood up and started to flail arms. Staff were present and in between residents at the time of the event to deescalate the situation. Remaining staff cleared dining room to ensure the safety of all other residents. R22 does not recall the incident and denies hitting anyone. The facility's undated Abuse Investigation documents a physical altercation occurred in the dining room with R22 striking R23. No injuries to R23. R23 approached R22, tapped R22's shoulder and yelled out. R23 stood up startled and began swinging his arms. Staff were immediately between the two residents. R22 did hit a staff member. All staff have interviews included in the investigation. The staff interviews for V4 CNA, V10 CNA, V35 CNA, and V43 CNA document they witnessed R22 attempting to hit staff members. V4 CNA witnessed R22 hit R23 and V35 CNA. V9 RN (Registered Nurse) documented multiple staff stated R22 hit multiple staff members and (R23). The investigation documents other residents were removed from the dining room. (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 8 Event ID: 146097 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 146097 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/18/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE El Paso Rehabilitation and Health Care Center 850 East Second Street El Paso, IL 61738 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)