Health inspection·July 1, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some temperature in the other room was very poor, too hot. R20 stated that R20 can't recall which day it was that R20 moved, but it was hot outside and hot inside the facility. R20 stated that R20 is blind and needed help to move. R20 stated that R20 complained to the nurse, and the nurse moved R20. R20's Face Sheet documents, in part, diagnoses of type 2 diabetes mellitus with diabetic retinopathy, orthostatic hypotension, hypertensive heart disease, difficulty in walking, lack of coordination, cognitive communication deficit, nicotine dependence, age-related nuclear cataract bilateral, and legal blindness. On 6/25/25 at 9:36 am, R15 stated that it was so warm in R12, R13, R14 and R15's room on 6/21/25, and the staff moved me out of the room that night. R15's Face Sheet documents, in part, diagnoses of chronic obstructive pulmonary disease, psychosis, and paranoid schizophrenia. On 6/25/25 at 9:42 am, R3 stated that for R3, R17 and R24's room AC unit in the ceiling, there was a problem where it had been dripping water, and the blower wasn't working. R3 stated that on 6/21/25, R3 read the air temperature reading on their room's thermostat at 87 degrees F with it being very warm R3's room. R3 stated that R3 was not moved from R3, R17 and R24's room on 6/21/25 or 6/22/25, and the facility brought in a portable AC unit. R3's Face Sheet documents, in part, diagnoses of asthma, polyarthritis, schizoaffective disorder, hypothyroidism, hypertensive heart disease, hyperlipidemia, major depressive disorder and nicotine dependence. On 6/25/25 at 9:45 am, R10 stated that R10 was in a room with R11 on 6/21/25, and it was hot and humid in their room. R10 stated that R10 was moved to a different room on 6/21/25 at night after the fire department staff arrived. R10's Face Sheet documents, in part, diagnoses of dementia, schizophrenia, obesity, major depressive disorder, and obesity. On 6/25/25 at 9:50 am, R24 stated that it was recently warm in R3, R17 and R24's room but was unable to provide additional details. R24's Face Sheet documents, in part, diagnoses of hypothyroidism, major depressive disorder, hypertension, hyperlipidemia, bipolar disorder, schizoaffective disorder, extrapyramidal and movement disorder, anxiety disorder, insomnia, legal blindness, and neoplasm of left kidney. On 6/25/25 at 9:53 am, R17 stated that water had been leaking from R3, R17 and R24's room AC unit in the ceiling recently and now it's been fixed. R17 stated that R17's naturally feels cold, so the warmth that R17 felt in R17's room was not a problem for R17. R17's Face Sheet documents, in part, diagnoses of chronic obstructive pulmonary disease, hypertensive heart disease, benign prostatic hyperplasia, hyperlipidemia, hypothyroidism, anemia, and tachycardia. On 6/25/25 at 10:00 am, R18 stated on 6/21/25, it was hot like a sun of a gun. R18 stated, Everyone knew that it was hot in here, I (R18) told them (staff) too, and R16, R18 and R25's room AC unit in (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146149 If continuation sheet Page 2 of 9 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 146149 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/01/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Westwood Vlge Nrsg and Rhb Ctr 2444 West Touhy Avenue Chicago, IL 60645 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 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some the ceiling wasn't working on 6/21/25. R18 stated that when the fire department staff came late in the evening on 6/21/25, then the staff moved R16, R18 and R25 to a different room in the facility. R18's Face Sheet documents, in part, diagnoses of hemiplegia affecting left dominant side, bipolar disorder, chronic obstructive pulmonary disease, type 2 diabetes mellitus, myelodysplastic syndrome, spinal stenosis, anemia, hypothyroidism, anemia, benign prostatic hyperplasia, chronic kidney disease, generalized anxiety disorder, schizoaffective disorder, and nicotine dependence. On 6/25/25 at 10:07 am, R16 stated that R16, R18 and R25's room AC wasn't working prior to 6/21/25, and the air temperature in their room kept going up. R16 stated that R16, R18 and R25 were moved to a different room in the facility late on 6/21/25. R16's Face Sheet documents, in part, diagnoses of chronic obstructive pulmonary disease, type 2 diabetes mellitus, hypertensive heart disease, generalized osteoarthritis, hyperlipidemia, benign neoplasm of parotid gland, hyperlipidemia, open-angle glaucoma, and Bell's palsy. On 6/25/25 at 2:47 PM, R14 stated that it was warm in R12, R13, R14 and R15's room recently but was unable to provide additional details. R14's Face Sheet documents, in part, diagnoses of asthma, schizophrenia, dementia, type 2 diabetes mellitus, gastrostomy status, epilepsy, chronic obstructive pulmonary disease, hypothyroidism, and glaucoma. On 6/25/25 at 2:49 PM, R4 stated that on 6/21/25 at night, R4 was moved from R2 and R4's room due to their room being warm with the AC unit in the ceiling not working. R4's Face Sheet documents, in part, diagnoses of type 2 diabetes mellitus, hypertensive heart disease, chronic obstructive pulmonary disease, anemia, schizoaffective disorder, hyperlipidemia, chronic kidney disease, low back pain, nicotine dependence, and sleep apnea. On 6/25/25 at 2:51 PM, R2 stated that R2 and R4's room in the facility was hotter than h*** on 6/20/25 and 6/21/25. R2 stated that R2 read their room air temperature on the thermostat as 88 degrees F on 6/21/25, and with the increased humidity, it felt hotter than 88 degrees F. R2 said that R2 complained to 2 nursing staff members on 6/21/25, and no one was doing anything. R2 stated that R2 called 911 around 6:30 PM on 6/21/25 telling the operator that the heat was unbearable in the facility. R2 stated that R2 spoke with the fire department staff in the facility in the evening on 6/21/25, and R2 and R4 were moved to separate rooms that night. R2's Face Sheet documents, in part, diagnoses of emphysema, chronic obstructive pulmonary disease end stage, severe protein-calorie malnutrition, hypertensive heart disease, cerebral infarction, cerebral ischemia, major depressive disorder, iron deficiency anemias, benign prostatic hyperplasia, dry eye syndrome and nicotine dependence. On 6/25/25 at 3:27 PM, R11 stated that R11 was moved from R10 and R11's former room on 6/21/25 due to the warmth in that room. R11's Face Sheet documents, in part, diagnoses of type 2 diabetes mellitus, schizoaffective disorder, chronic kidney disease stage 3, hypertensive heart disease, orthostatic hypotension, hyperlipidemia, major depressive disorder, benign prostatic hyperplasia, obstructive sleep apnea, and chronic (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146149 If continuation sheet Page 3 of 9 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 146149 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/01/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Westwood Vlge Nrsg and Rhb Ctr 2444 West Touhy Avenue Chicago, IL 60645 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 0584 respiratory failure. Level of Harm - Minimal harm or potential for actual harm On 6/25/25 at 3:32 PM, R25 stated that it was warm in R16, R18 and R25's room on 6/21/25, and they were moved to a different room in the facility later that night. Residents Affected - Some R25's Face Sheet documents, in part, diagnoses of hypertension, hyperlipidemia, schizoaffective disorder, hypothyroidism, open-angle glaucoma bilateral, and cataract. On 6/25/25 at 3:34 PM, R22 stated that it was getting warmer in R22 and R23's room on 6/21/25, but they stayed in their room. R22's Face Sheet documents, in part, diagnoses of chronic obstructive pulmonary disease, combined systolic and diastolic (congestive) hear failure, hypothyroidism, major depressive disorder, schizoaffective disorder, sciatica, hyperlipidemia, and migraine. On 6/30/25 at 1:07 PM, R23 stated that R22 and R23's room AC unit wasn't working right, and there's a portable AC unit in R22 and R23's room due to room being warm. R23's Face Sheet documents, in part, diagnoses of dementia, polyneuropathy, type 2 diabetes mellitus, chronic obstructive pulmonary disease, paroxysmal atrial fibrillation, post-traumatic stress disorder, osteoarthritis, low back pain, major depressive disorder, and sleep apnea. On 6/30/25 at 1:09 PM, R13 stated that R12, R13, R14 and R15's room was real warm on 6/21/25, and the fan that was provided by staff in their room wasn't helping to cool the room. R13 stated that R13 was moved to a different room at night on 6/21/25 because it was too hot in their room. R13's Face Sheet documents, in part, diagnoses of hypertensive heart disease, iron deficiency anemia, paranoid schizophrenia, pain in hip and knee, and osteoarthritis. On 6/30/25 at 1:11 PM, R12 stated that R12, R13, R14 and R15's room was very warm on 6/21/25, and the fan that was provided by staff in their room wasn't helping to cool the room. R12 stated that R12 was moved to a different room at night on 6/21/25. R12's Face Sheet documents, in part, diagnoses of type 2 diabetes mellitus, epilepsy, dysphagia, paranoid schizophrenia, hypothyroidism, hyperlipidemia, and edema. On 6/30/25 at 1:15 PM, R21 stated that R21 was moved from R19 and R21's former room due to it being so hot, and the AC unit in their former room was broken. R21's Face Sheet documents, in part, diagnoses of chronic obstructive pulmonary disease, schizophrenia, type 2 diabetes mellitus, hypertensive heart disease, respiratory failure, epilepsy, absolute glaucoma bilateral, psoriasis and sudden idiopathic bilateral hearing loss. On 6/30/25 at 1:18 PM, R19 observed in R19 and R21's new room and not responding verbally to surveyor questions. R19 nodded yes to moving to a different room due to elevated air temperature in the former room. R19's Face Sheet documents, in part, diagnoses of Parkinson's disease, chronic obstructive pulmonary disease, emphysema, schizophrenia, severe protein-calorie malnutrition, systolic (congestive) (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146149 If continuation sheet Page 4 of 9 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 146149 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/01/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Westwood Vlge Nrsg and Rhb Ctr 2444 West Touhy Avenue Chicago, IL 60645 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 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some heart failure, retention of urine, hypertensive heart disease, benign prostatic hyperplasia, major depressive disorder, and post-traumatic stress disorder. On 6/30/25 at 1:20 PM, R6 stated, It was so hot, I (R6) couldn't sleep. R6 stated that the AC unit in the ceiling in R6 and R7's room was broken. R6 stated that the staff knew about the hot situation on 6/21/25, and that one unknown female staff member had come into R6's room saying that it was hot in this room. R6 stated that then the fire department staff came that night (6/21/25-6/22/25), and the facility staff then moved R6 and R7 to a different room. R6's Face Sheet documents, in part, diagnoses of type 2 diabetes mellitus, schizoaffective disorder, generalized anxiety disorder, delusional disorders, and nicotine dependence. On 6/30/25 at 4:14 PM, R7 stated that R7 was moved to a different room and is happy to be back in R6 and R7's room with the AC unit fixed. R7's Face Sheet documents, in part, diagnoses of vascular dementia, chronic obstructive pulmonary disease, hypertensive heart disease, hyperlipidemia, osteoarthritis, major depressive disorder, respiratory failure, schizophrenia, severe protein-calorie malnutrition, syncope and collapse, convulsions, epilepsy, absolute glaucoma bilateral and polydipsia. On 6/24/25 at 2:29 PM, V5 (Licensed Practical Nurse/LPN) stated that there were four nurses assigned and working on 6/21/25 for the 7:00 am to 3:00 PM shift, and V5 was working on side 1. V5 stated that a majority of V5's residents' rooms were cool; however, several rooms V5 noted that the AC was not working well like it wasn't working fast enough. V5 stated that R19 and R21's room was warm. V5 stated that there was a manager on duty (MOD) who was the DON, V2 (Director of Nursing/DON), and that V5 did not notify V1 (Administrator) or V2 of R19 and R21's room air temperature being too warm on 6/21/25. On 6/24/25 at 2:47 PM, V6 (LPN) stated that V6 was working on 6/21/25 during the 7:00 am to 3:00 PM shift, and V6 was assigned to side 4. V6 stated that when V6 walked through the hallway passing by resident rooms on side 3, V6 stated, It was so hot. V6 stated that some residents had towels on the floor due to the AC units in the ceiling leaking water to the floor. V6 stated that some residents were stepping out of their rooms saying that it's too warm in their rooms, including R16. V6 stated that V6 did know what happened to R16's leaking AC unit but it was so hot in that room. V6 stated that V6 did not report to nobody. I won't lie. I didn't. I didn't talk to the next shift (oncoming evening shift). It's the AC, there's nothing that I can do about it. Besides it's Saturday (6/21/25). They (residents) have to wait to Monday. On 6/24/25 at 3:02 PM, V7 (Certified Nursing Assistant/CNA) stated that V7 worked on 6/21/25 from 7:00 am to 3:00 PM and was assigned to side 3. V7 stated that some resident rooms felt warm that day, including R2 and R4's room. V7 stated that R2 was complaining that it was too hot in R2 and R4's room, and V7 stated that it felt warm over there on side 3. V7 stated that V7 had informed V3 (Housekeeper) of the increased air temperature while working on 6/21/25. On 6/24/25 at 3:41 PM, V8 (LPN) stated that V8 was working on 6/21/25 from 3:00 PM to 11:00 PM and was assigned to side 1 residents. V8 stated that one resident, R20, complained of it being too warm in R20's room. V8 stated that it was hot outside and that R20 had just come back from being outside in the smoking patio so asked R20 to give it some time for R20's room to cool down. V8 stated that around 6:00 PM on 6/21/25, R20 was still complaining of R20's room being too warm, so V8 moved R20 to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146149 If continuation sheet Page 5 of 9 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 146149 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/01/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Westwood Vlge Nrsg and Rhb Ctr 2444 West Touhy Avenue Chicago, IL 60645 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 0584 Level of Harm - Minimal harm or potential for actual harm a different room. V8 stated that around 10:00 PM, a fire department staff member entered the facility telling V8 that a resident had called saying that the temperature was unbearable in the facility. V8 stated that V8 instructed V19 (Registered Nurse/ RN) to call V1 (Administrator), and V8 then phoned and notified V2 (DON) about the fire department staff wanting to tour the facility to check on residents' welfare. V8 stated that V2 was working in the facility on 6/21/25 as the MOD but left the facility around 6:00 PM. Residents Affected - Some On 6/24/25 at 3:54 PM, V9 (RN) stated that V9 worked on 6/21/25 from 7:00 am to 11:00 PM. V9 stated that one resident, R2, came up to the nurse's station to complaint about R2's room being too hot. V9 stated that V9 would normally call the MOD about elevated room air temperatures, but R2 wasn't on my side. On 6/24/25 at 4:01 PM, V19 (RN) stated that V19 worked on 6/21/25 from 3:00 PM to 11:00 PM and was working on side 2. V19 stated that R2 complained of R2 and R4's room being too warm, and V19 investigated by walking into R2's room which was warm with the AC unit not working. V19 stated that around 10:00 PM when the fire department staff entered the facility, V19 then called and notified V1 (Administrator). On 6/25/25 at 3:44 PM, V10 (CNA) stated that V10 worked on 6/21/25 from 3:00 PM to 11:00 PM, and V10 worked on side 2 and 3. V10 stated that at 3:00 PM on 6/21/25 during rounds, V10 observed R2 talking the nurse about the heat in R2's room. V10 stated V6 (LPN) checked on R2's room. V10 stated that some other resident rooms were not much cool but (V10) didn't look at the thermostat but it was like a tropical heat. V10 stated that around 9:30 PM to 10:00 PM, the fire department staff entered the facility. On 6/25/25 at 11:37 am, V3 (Housekeeper) stated that V3 is a housekeeper and when V1 needs an extra hand, I am maintenance. V3 stated that the one maintenance staff for the facility is V21 (Maintenance Director) but V21 is currently on vacation. V3 stated that V3's responsibilities are to mop and sweep all resident rooms and communal areas and cleans the bathrooms and shower rooms. V3 stated that V3 is also responsible to catalog the (air) temperatures in (resident rooms), and V3 does this by looking at the actual air temperature reading on the AC thermostats in each resident room. V3 stated that V3 is looking for readings of 72 to 74 degrees F. V3 stated that for air temperature readings greater than 74 degrees, V3 will tell V24 (Housekeeping Director) on Tuesdays, Thursdays and Saturdays when V24 is working and will tell V1 on the other days. V3 stated that V3 documents each air temperature reading from residents' rooms on the air temperature log. V3 stated that V3 will collect the resident room air temperature readings in the morning time and the air temperature readings normally rise throughout the daytime. V3 stated that V3 worked on 6/21/25 from 7:00 am to 3:00 PM, and it didn't start heating up until to 2 PM. After that 2 PM, I (V3) think its spiked. I didn't get no temps because I got them in the morning. I left at 3 PM. Me, I was feeling it (heat in the facility). V3 stated that V3 had addressed several residents' complaints of their rooms being too hot with their AC units leaking water. When asked if V3 notified V1, V21 (Maintenance Director) or V24 (Housekeeping Supervisor) on 6/21/25 of the leaking AC units or residents' complaints of feeling too hot in their rooms, V3 stated, I didn't tell anyone. On 6/25/25 at 1:40 PM, V2 (DON) stated that V2 was working as the MOD on 6/21/25 onsite in the facility from approximately 8:00 am to 6:00 PM. V2 stated that as the MOD, V2 is responsible for ensuring that residents are being taken care of and to oversee the functioning of the facility and staff. V2 stated that on 6/21/25, the heat index outside was 104 degrees F and that V2 placed a hold on residents leaving the facility on community passes due to the excessive hot weather. V2 stated that on (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146149 If continuation sheet Page 6 of 9 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 146149 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/01/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Westwood Vlge Nrsg and Rhb Ctr 2444 West Touhy Avenue Chicago, IL 60645 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 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some 6/21/25, V2 did address R2 saying that it was too hot in R2 and R4's room by shutting the room window. V2 stated that V2 received no reports from the facility staff on 6/21/25 about the facility feeling too warm. V2 stated that V2 left the facility around 6:00 PM, and later V8 (LPN) phoned notifying V2 that someone called 911 about the facility being too warm. On 6/24/25 at 9:52 AM, V1 (Administrator) stated that on 6/21/25 while at home, V1 received a phone call from V19 (RN) stating that someone called the fire department saying that the rooms were too hot. V1 stated, I did not get a phone call, so I didn't know there was an issue. I was at home. Once I got the call that they were here, I got here within 10 minutes. V1 stated that V1 performed a tour with the fire department staff who was taking air temperature readings with their equipment with elevated air temperature readings is some resident rooms. V1 stated that with the directive of the fire department staff, V1 must move the residents from their rooms to a cooler room in the facility if the room air temperature was 85 degrees or higher. V1 stated that on the night of 6/21/25 to into 6/22/25, R2, R4, R6, R7, R8, R10, R11, R12, R13, R14, R15, R16, R18, R19, R21 and R25 were all relocated to different rooms in the facility, with R9 refusing to move. V1 stated that with the directive of the fire department staff, V1 must monitor the air temperature room readings hourly, and for resident rooms reading 80 to 84 degrees F, these residents must be monitored closely. This surveyor and V1 reviewed the hourly air temperature readings starting at midnight on 6/22/25, and V1 stated that V1 phoned the contracted air conditioning company, and early Sunday on 6/22/25, they ran a diagnostic test on the air conditioning system in the facility. V1 stated that when the air conditioning system was turned on by the contracted air conditioning company personnel on 6/2/25, only one AC pump was turned on instead of both AC pumps. V1 stated that some of the residents' room AC units were then overworking and malfunctioned. On 6/30/25 at 11:36 am, V1 confirmed that the resident census on 6/21/25 was 102 active residents. V1 stated that V21 is the Maintenance Director and has not been working (on vacation) since 6/17/25. V1 stated that V3 is a housekeeper and will change AC filters, but V3 does not perform maintenance repairs. V1 stated that staff will inform V1 or V21 of maintenance concerns, and V1 will make final decisions. In reviewing with V1 the facility policy for extreme high temperatures, this surveyor asked who the VP (Vice President) of Plant Operations or VP of Regional Operations is. V1 stated that V1 doesn't know and that V1 contacts the facility owners with extreme high temperature concerns in the facility. Facility temperature log, dated 6/22/25 from 12 am to 1 am, document, in part, air temperatures of four rooms at 82 degrees F; one room at 83 degrees F; three rooms at 84 degrees F, and one room at 85 degrees F. Facility temperature log, dated 6/22/25 from 1 am to 2 am, document, in part, air temperatures of three rooms at 82 degrees F; three rooms at 83 degrees F; and two rooms at 84 degrees F. Facility temperature log, dated 6/22/25 from 2 am to 3 am, document, in part, air temperatures of three rooms at 82 degrees F and one room at 83 degrees F. Facility temperature log, dated 6/21/25, documents only one temperature reading for each resident room. Facility floor plan reviewed showing that the facility has one floor (main level) where residents reside. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146149 If continuation sheet Page 7 of 9 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 146149 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/01/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Westwood Vlge Nrsg and Rhb Ctr 2444 West Touhy Avenue Chicago, IL 60645 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 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Facility Resident Roster, titled Midnight Census Report and dated 6/21/25, indicates that 102 active residents are residing in the facility. Facility employee list documents, in part, one maintenance staff member, V21 (Maintenance Director). Online review of the outside weather on 6/21/25 documents that the high temperature was 95 degrees F at 2:53 PM. Facility policy titled Extreme High Temperature Guideline dated 4/3/2024, documents, in part, Purpose: To provide guidance to facility in times of unseasonably hot weather and/or cooling system malfunction. Responsible Party: Facility Staff. Should the temperature index for relative humidity and temperature in this facility rise above 80°, the facility shall implement the appropriate high temperature procedures. Should a specific area of the facility rise above 80°, it may be necessary to relocate residents to a cooler section of the facility . Department Specific Procedures: Nursing: . if necessary, transfer residents to areas of the facility that are better ventilated and cooler in temperature . Maintenance: monitor air temperatures at least every two hours between 8:00 AM and 10:00 PM in resident areas and every four hours between 10:00 PM and 8:00 AM temperatures should be taken at the warmest point identified through baseline monitoring on each floor or wing . Housekeeping and Laundry: . report any repairs to the supervisor or the director of maintenance. Administration: Alert all Extended Care V.P. of Plant Operations and the V.P. of Regional Operations regarding the high temperature situation if high temperature. (If) procedures do not sufficiently maintain resident safety. Facility policy titled Resident Rights Guidelines dated October 2023 documents, in part, . Guideline: our residents have certain rights and protections under federal law that help ensure appropriate care and services are provided . our facility will treat each resident with respect and dignity and care for each resident in a manner an (and) in an environment that promotes maintenance or enhancement of his or her quality of life . right to a safe, clean, comfortable, and home like environment . housekeeping and maintenance for a safe, sanitary, orderly, and comfortable interior . and safe temperatures. Facility policy titled Maintenance Policy dated January 2025 documents, in part, Policy: it is the policy of this facility to provide a safe, accessible, effective and efficient environment of care that is consistent with its mission, services and law and regulations. Policy Specifications: To ensure that the building (interior and exterior), grounds, and equipment are maintained in a safe operable manner. Responsibility: Maintenance Direct and Maintenance Personnel. Standards: . 14. Air-conditioning system shall be maintained and utilized as necessary to provide comfortable temperatures in all areas. Air temperature shall be maintained in a temperature range of 71 to 81 (degrees) F. Facility job description (undated) titled Director of Nursing documents, in part, . The primary purpose of your position is the provision of nursing care and treatments to residents. All services provided shall be in accordance with established nursing standards, policies, procedures, and practices of this facility and the requirements of this state . Major Duties and Responsibilities: . 1. Demonstrate understanding and utilize nursing policies and procedures in the administration of resident care. 2. Direct day-to-day functions of the nursing assistants in accordance with current rules, regulations and guidelines. Ensure that all nursing personnel comply with the written policy and procedures established by the facility . 5. Follow facilities guidelines for reporting all activity during scheduled shift . 41. Responsible to supervise day-to-day activities of all nursing staff . 44. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146149 If continuation sheet Page 8 of 9 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 146149 B. Wing A. Building (X3) DATE SURVEY COMPLETED 07/01/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Westwood Vlge Nrsg and Rhb Ctr 2444 West Touhy Avenue Chicago, IL 60645 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 0584 Ensure that the highest degree of quality care is provided at all times. Level of Harm - Minimal harm or potential for actual harm Facility job description (undated) titled Charge Nurse Duties and Responsibilities documents, in part, to provide direct nursing care to residents and supervised the daily nursing activities of nursing staff in accordance with federal, state, and local standards, guide lined by regulations that govern the facility. Residents Affected - Some Facility job description (undated) titled CNA Job Description documents, in part, that the CNA will report to the nurses and DON and must have qualifications to safely and successfully perform job-related functions that are required by federal, state, or local law. Facility job description (undated) titled Maintenance Supervisor documents, in part, Reports to: Administrator. Purpose: The purpose of this position is to: ensure that the facility environment, grounds and equipment is maintained in good, safe operating order . Maintain all established OSHA (Occupational Safety and Health Administration), State and Federal regulations regarding environmental . develop, implement and maintain, with facility administration approval, policies and procedures to assure compliance with all federal, state and local regulations . Duties/Responsibilities/Function: . Assure timely and consistent policy compliance with the following items: . 13. AC/Heating System Maintenance. Facility job description (undated) titled House Keeping Aid documents, in part, . provide housekeeping services to assure that a clean, orderly and home like environment is maintained in accordance with current federal, state and local regulations . Duties/Responsibilities/Function: . maintain all safety rules and regulations. Comply with all facility policies and procedures. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 146149 If continuation sheet Page 9 of 9