Inspection·September 26, 2024

F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to ensure a physician ordered medicated cream was applied for 1 of 3 residents (R2) reviewed for medications in the sample of 5. The findings include: R2's face sheet showed he was admitted to the facility on [DATE] with diagnoses to include metabolic encephalopathy, absence epileptic syndrome, Type 2 Diabetes, paraplegia, and morbid obesity. R2's facility assessment dated [DATE] showed he has no cognitive impairment. R2's September 2024 eMAR (electronic Medication Administration Record) showed Nystatin Cream was documented as see other progress notes on 9/17/24, 9/19/24, and 9/20/24. R2's Progress Note dated 9/20/24 at 10:19 PM, showed, . Nystatin External Cream . Apply to BILATERAL BUTTOCKS topically every shift for SKIN CONDITION . on order R2's Progress Note dated 9/18/2024 at 12:24 AM showed, . Nystatin External Cream . Apply to BILATERAL BUTTOCKS topically every shift for SKIN CONDITION . in process to be delivered R2's Progress Note dated 9/19/24 at 10:43 PM showed, . Nystatin External Cream . Apply to BILATERAL THIGHS topically every shift for SKIN CONDITION . ordered in pharmacy. R2's Progress Note dated 9/18/2024 at 6:25 AM showed, . Nystatin External Cream . Apply to BILATERAL THIGHS topically every shift for SKIN CONDITION . in process to be delivered R2's 9/20/24 nursing note entered at 11:11 PM showed, Resident complaining of neglect, writer asked why and resident replied with 'I haven't gotten my Nystatin cream, I want to speak to the DON (Director of Nursing)' writer explained it was reordered this morning. Endorsed concerns to night shift nurse . On 9/25/24 at 11:16 AM, R2 said, . Nystatin cream, several doses I didn't get it because they ran out of it. They said they needed to order it. They ran out on my morning dose and then it took over another full day for it to come. They commented that I use it so much that it ran out. It is their responsibility to order it when they apply it and see it is going to be out . The facility's policy and procedure with revision date of 01/2022 showed, Reordering Medications . Policy/Purpose: Medications are ordered in advance so as not to have lapses in therapy . Medications (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: 146186 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 146186 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/26/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Alden Estates Cts of Huntley 12140 Regency Parkway Huntley, IL 60142 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)