Inspection·January 21, 2025

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to assess and identify open areas to the right and left buttocks, this failure resulted in R1's open areas becoming full thickness for 1 of 3 residents (R1) reviewed for pressure injury in the sample of 3. Residents Affected - Few The finding include: R1's Physician Order Sheet printed on 1/21/25 show R1 was admitted to the facility on [DATE] with diagnoses of pancreatic cancer, Type 2 diabetes, and chronic kidney disease. R1's facility assessment dated [DATE] show R1 has no cognitive impairment. (BIMS-15) R1's Braden scale (predicting of risk of pressure injury) dated 12/20/24 show R1 is at risk to develop a pressure injury. R1's skin admission assessment dated [DATE] show R1 had redness to his bottom but no open areas. On 1/21/25 at 9:10 AM, R1 said he was having so much pain in my bottom, I was complaining about it, until they saw that I had an open sore while they were cleaning and changing me. R1 said he did not have any wounds on his bottom when he first came at the facility (12/13/24.) On 1/21/25 at 10AM, V9 (Wound Nurse) provided wound care to R1. V9 removed the soiled dressing from the right and left buttocks. There were open areas to R1's right and left buttocks. V9 said she was informed of R1's open areas on 1/9/25. V9 said she took pictures and sent them to V10 (Wound Physician). V10 was then at the facility last 1/15/25 and assessed R1's wounds. R1 had no other skin assessments in R1's medical record after R1's initial skin assessment (12/14/24). R1 had no skin assessments the week of: 12/16/24, 12/23/24 and 12/30/24 (no skin assessments for 3 weeks) prior to a progress note on 1/9/25 when the open wound to right and left buttocks were discovered. Skin opening noted to right and left buttocks . Area cleanse with normal saline . R1's Wound assessment dated [DATE] by V10 documents, initial wound assessments on the right buttocks-full thickness 5.0 centimeters (cm) x 3.5 cm x 0.1 cm. Initial assessments left buttocks-full thickness 3.5 cm x 1.5 cm x 0.1 cm treatment with date of order (1/15/25) to right and left buttocks-mupirocine 2% with santyl and lidocaine jelly with calcium alginate cover with foam dressing. On 1/21/25 at 1:30 PM, V2 (Director of Nursing/DON) said skin assessments should be done upon admission and then weekly. V2 said the skin assessments on 1/9/25 was when the open areas on right and (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 3 Event ID: 146136 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 146136 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Radford Green 960 Audubon Way Lincolnshire, IL 60069 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)