Health inspection·June 26, 2025

F 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few On 6/24/2025, at 1:19 PM, V12 (family member) stated, Basically it started beginning to middle of May. Her (R1's) card was stolen. I knew it was a Thursday night, and I knew something was going on, because I got a bunch of google security alerts. I called (R1) like 10 times and she did not answer. Around 5 AM, one of the staff members called and said her phone was missing. I said that someone stole it, and told her about the google alerts. I bought (R1) an iPhone for this purpose so I could track it. On Thursday night, the phone showed it was still at nursing home. Then the next morning, Friday, it showed it was off. I kept checking it throughout the morning, and at about 8:45 AM it was on and showed it was at the nursing home. So that is when I called the nursing home and asked to speak to someone in charge, and they passed me on to the Administrator (V1). I told (V1) the phone was gone, and it is on, and they can't find it. (V1) was going to go check (R1's) room for it. About 2-3 hours later, they said they can't find it. I looked when I spoke to them, and the phone was off. So, then facility called the police and made a police report. On Friday night when I got back to my job, I realized I had 2 missed calls from (R1). I called (R1) back. It was an older gentleman saying he found the phone on the street by a school in the community. I did let him know that it was a stolen phone, and the police were involved. I asked him to turn it in to the police station. He would not, but me and my husband picked it up from the man and took to (R1). So now (R1) got her phone back, (V1) said they would investigate it, but they stopped investigating. Towards the end of May, I received a bill in the mail for (R1's) card for $833.31. I flipped my lid. When I opened the mail, I immediately went to the nursing home and showed (V1). We went through everything, and verified (R1) did not have her card. So, we went looking for her other cards. Whatever other cards (R1) had with her, I took with me. (R1's) bank card was charged $8.09. I thought maybe she let someone go get her fast food, and (R1) said no. (R1) did have the debit card with her. I called (R1's) bank and they told me there was suspicious activity on (R1's) account. Me and (R1) had to call together, and they said someone was trying to use an application to buy stuff. They tried several times, but the bank would not let it go through. They said it was done virtually. Police were called police report was made. The credit card is now $0. The debit card only had the $8.09 for fast food charged. There was an arrest made. Police would not tell me who it was, but the nursing home told me they arrested her right from the nursing home. From what the detective told me, the only charges they could charge her with was for one retail store a class 3 felony because of (R1) being over [AGE] years old, because it was elder abuse and identity theft. On Sunday when I went to the facility, I left a copy of (R1's) credit card statement for (V1's) records. It was showing the whole list of charges. As far as I know, that is all. The charges started on May 5, 2025, and the last charge was June 9,2025. The total of the charges was over $2000. On 6/24/2025, at 2:31 PM, V11, Social Service Director, stated, I was involved in the issue with (R1's) credit card/debit card situation. It was reported to (V15, Social Service Assistant) that (V12), family member of (R1), had reported unauthorized charges to (R1's) credit/debit card. At that point, (V15) reported to abuse coordinator, (V1), the Administrator. My assistant (V15) met with (V12, family member) and went over the charges on the card. They were to 3 stores. We started the investigation immediately. With our investigation we really did not find out anything. A police report was made with the police department. Police (V17 and V18) came here and showed us a picture of the offender (V14, LPN) and asked if we could identify the offender, and I brought the police to (V1, Administrator) and (V1) identified the offender as (V14, LPN). (V14, LPN) was scheduled to work the 3-11 pm shift later that day. From my knowledge, (V14, LPN) just happened to be walking in the building and the police were here. (V14, LPN) got arrested here at the facility. On 6/24/2025, at 3:31 PM, V1, Administrator, stated, Regarding the credit card theft for (R1), it (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146132 If continuation sheet Page 2 of 6 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 146132 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/26/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ryze at Homewood 19000 South Halsted Homewood, IL 60430 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 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few unfolded with (V12, family member) came in with some unauthorized charges to (R1's) credit card. (V12) said the charges began around the beginning of May, and that (R1) had not used the card, and no one else was authorized to use the card. At that point, we started an investigation, called the police, and made a police report. We started interviewing staff. Most staff said they were unaware and had no information to give. We also interviewed (R1), and asked if she had given card to staff to help her use card, and she said no. So, at that point we were unable to determine anything. I followed up with (V12, family member) and she stated she had been working with the police department and they initiated an investigation. So, it was quiet after that; we could not substantiate anything on our end. This past Thursday, two detectives came in (V17 and V18) and stated they had a person of interest. They had a photograph, and wanted to know if that person was employed, or ever employed here. When they showed me the photo, I did recognize her as one of our nurses (V14, LPN) on staff. I contacted Human Resources because they were requesting (V14's) name, address, phone number, and all that information. At the time, (V14, LPN) was noted coming into the building from her break. The police were notified that (V14) was their person of interest. The police (V17 and V18) arrested (V14) here in the building that day. All of this was around 1:30 in the afternoon. So, at the end of the day, as I was leaving that evening about 6 pm, I received a phone call from the detective asking if I was still in the building. I told him I was in the parking lot. He was requesting any paperwork with (V14's) date of employment on it. Once he arrived, he requested if he could interview the resident as well. I accompanied the two detectives (V18 and V19) up to her room. (V18 and V19) showed her the picturej and asked if she could identify that person. (R1) said no. (R1) was asking names, and the officers said they were limited with the information they could give at that time, but they would send us a complete report at the completion of their investigation. (V14, LPN) is terminated in our system. I did not do the termination; I would have to find out what reason they put down for the reason of termination was. We did not receive a full police report yet, I think it is still ongoing at this point. I have not yet reported this to IDPH licensure. For the allegation of theft, the final was unsubstantiated, because (R1) did not know when she last had the card, or where (R1) had the card. I could not verify if the card was ever here. My expectation of staff regarding abuse and theft is that it doesn't happen, and if it does happen, that the resident is provided with safety, and it is reported immediately. On 6/24/2025, at 3:06 PM, V2, Interim Director of Nursing (DON), stated, I have been assisting the Administrator (V1) with the theft allegation a bit. I do not know anything about the police investigation regarding the theft because I was away at a meeting and was not here. I did hear someone was arrested here for the theft, but am unaware of the details. As interim DON, my expectation of staff regarding abuse and theft would be to report it immediately if it happens and that it don't happen. Progress note, dated 6/6/2025, documents: Resident's family member informed staff of alleged financial abuse. Resident's credit card was stolen with unauthorized charges of over $800. Administrator made aware; staff will continue to monitor. On 6/25/2025 at 10:39 AM, Inventory of R1's personal effects list, dated 4/6/2025, lists 3 credit cards/debit cards/checks, as well as other items. On 6/25/2025, at 1:58 PM, Daily Schedules were reviewed, and V14, LPN, time punches for May 2025 and June 2025 and cross referenced them. V14, LPN, worked on hall 700/800 on May 1, 2025, clocked in at 3:00 pm and clocked out at 8:15 am. V14, LPN, worked a double shift on hall 700/800. On May 4, 2025, V14, LPN, also worked a double shift on hall 700/800 clocking in at 3:00 PM and clocked out at 7:30 AM. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146132 If continuation sheet Page 3 of 6 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 146132 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/26/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ryze at Homewood 19000 South Halsted Homewood, IL 60430 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 0602 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Per census report R1 resides on hall V14 worked on. Administrator states she has been in this room since 2/19/2025. License look up detail from Illinois Department of Professional Regulation, dated 4/17/2025, provided to surveyor from facility Human Resource file for V14, LPN, documents: Probation discipline start date 11/4/2009 discipline end date 11/3/2010 reason for action: license returned to probation for one year. Suspension discipline start date 1/14/2009, discipline end date 11/4/2009 reason for action: licensed practical nurse license indefinitely suspended for a minimum of six months due to a felony conviction. Probation discipline start date 5/2/2016, discipline end date 11/26/2018 reason for action: for a 2014 Class 4 Felony Conviction regarding Aggravated Fleeing. Police Report, dated 6/6/2025, documents: In summary, I (V16) met with the complainant (V12) at facility in reference to a theft and deceptive practice. The complainant (V12) is the niece of the victim (R1). (R1) is confined to her bed so her niece was filing the report on her behalf. The complainant (V12) advised she handles the victim (R1's) finances and discovered fraudulent charges on her credit card and her debit card starting 5/9/2025. When complainant (V12) inquired about the charges to (R1), she discovered both cards were missing from her room. The complainant provided me a monthly statement from credit card and bank. The complainant (V12) stated the victim (R1) wished to sign complaints and did not give any staff or anyone else permission to use her cards on her behalf. Police report, dated 6/18/2025, documents: On 6/17/2025 Retail store loss prevention tendered me a video and a receipt for the transaction that was charged to (R1's) credit card. I (V17) sent a screen shot of the offender and a clip of the offender exiting the store for facial recognition. Police report, dated 6/18/2025, documents: On 6/17/2025 I (V17) met with retail store loss prevention who provided me video and receipts for the transactions that occurred on (R1's) credit card. Police report, dated 6/20/2025, documents: On 6/19/2025 another investigator (V18) and I (V17) went to facility in an attempt to identify offender. I met with (V11, Social Service Director) and showed her a still shot of the offender from the retail store incident and she stated we need to talk to the Administrator (V1). (V11) stated that the person in the picture was a nurse at the facility, (V14, Licensed Practical Nurse (LPN)). We went to the Administrators (V1's) office, where I showed her the still picture and she identified the offender as (V14, LPN). While speaking with (V1) Administrator, (V14) entered the facility, when they told her she had to go to the Administrators (V1's) office, (V14, LPN) exited out the facility, where another investigator and I placed her into custody. (V14, LPN) was transported to police department, while inventorying her property, the other investigator located a retail store receipt from 6/7/2025 where (R1's) credit card was used to complete the purchase, in (V14, LPN's) purse. Police report, dated 6/20/2025, documents: On 6/19/2025 at approximately 2:21 PM I (V17) read (V14, LPN) her [NAME] warning, in the presence of another investigator (V18). (V14, LPN) stated she understood her rights, signed and initialed the form. (V14, LPN) agreed to speak with us. The following non-verbatim summary of the interview: (V14, LPN) acknowledge that it was her in the still pictures I showed her at both retail stores. (V14) stated she found the credit card in the parking lot of the facility and used it approximately 5 times. (V14) stated a couple of days ago staff was talking about (R1's) credit card been stolen and used and that is when she put it together. The interview was audio and video recorded and uploaded into evidence. Police report, dated 6/20/2025, documents: (V1) provided documentation to investigators (V18 and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146132 If continuation sheet Page 4 of 6 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 146132 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/26/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ryze at Homewood 19000 South Halsted Homewood, IL 60430 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 0602 Level of Harm - Minimal harm or potential for actual harm V19) that (V14) was an employee at facility from 4/23/2025 till 6/19/2025, and she was terminated based off our arrest. (V1) advised that their cameras just became operational approximately a week or two ago. Investigators showed (R1) a still picture from retail store and (R1) advised them that she does not recognize the person in the picture and (R1) did not give her (V14) permission to use her credit card. (R1) stated her credit card was kept in her purse that was on the nightstand in her room. Residents Affected - Few Abuse Policy and Prevention Program Policy, dated 10-2022, documents: Abuse Policy This facility affirms the right of our residents to be free from abuse, neglect, exploitation, misappropriation of property, deprivation of goods and services by staff or mistreatment. This facility therefore prohibits abuse, neglect, exploitation, misappropriation of property, and mistreatment of residents. In order to do so, the facility has attempted to establish a resident sensitive and resident secure environment. The purpose of this policy is to assure that the facility is doing all that is within its control to prevent occurrences of abuse, neglect, exploitation, misappropriation of property, deprivation of goods and services by staff and mistreatment of residents. This will be done by: Conducting pre-employment screening of employees and pre-admission screening of residents; Orienting and training employees on how to deal with stress and difficult situations, and how to recognize and report occurrences of abuse neglect, exploitation, and misappropriation of property; Misappropriation of Resident Property means the deliberate misplacement, exploitation, or wrongful temporary, or permanent use of a resident's belongings or money without the resident's consent (42 CFR 483.5). Misappropriation of a resident's property means the deliberate misplacement, exploitation, or wrongful temporary or permanent use of a resident's belongings or money without the resident's consent (210 ILCS 45/1-116.5) III. Orientation and Training of Employees During orientation of new employees, the facility will cover at least the following topics: Sensitivity to resident rights and resident needs; What constitutes abuse, neglect, exploitation, and misappropriation of resident property; The prohibitions against taking, using, keeping, or distributing photographs or recordings of residents or residents' personal space, as described in Section IV below. Procedures for reporting incidents/allegations of abuse, neglect, exploitation or the misappropriation of resident property; Dementia management and resident abuse prevention; How to assess, prevent and manage aggressive, violent and/or catastrophic reactions of residents in (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146132 If continuation sheet Page 5 of 6 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 146132 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/26/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Ryze at Homewood 19000 South Halsted Homewood, IL 60430 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 0602 a way that protects both residents and staff; Level of Harm - Minimal harm or potential for actual harm An employee's obligation under the law for reporting a suspected crime to the facility, the state survey agency and local law enforcement; the time frames for reporting; and management's obligation to prohibit retaliation against anyone who makes a report. Residents Affected - Few On an annual basis, staff and all covered persons will receive a review of above topics. On an annual basis, supervisory personnel will receive training on their obligations under law when receiving an allegation of abuse, exploitation, neglect or misappropriation of resident property, and how to monitor and correct inappropriate or insensitive staff actions, words or body language FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146132 If continuation sheet Page 6 of 6