Grove Of Skokie, The

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review the facility failed to provide needed care and services in accordance with resident's plan of care as ordered by physician, facility's protocol, and professional standard of practice. This deficiency affects two (R2 and R4) of three residents reviewed for Quality of care. Findings include:R2On 9/2/25 at 10:21AM, Observed R2 up in wheelchair. She is alert with cognitive and communication impairment due to intellectual disability. She needs assistance with ADLs (Activity of daily living) and transfers. Assessed skin condition of R2's bilateral under the breast with V8 LPN (Licensed Practical Nurse) and V9 CNA (Certified Nurse Assistant). Observed redness under both breasts. V9 CNA said that she applied this morning Vitamin D ointment. V8 LPN said that R2 has fungal rash, and she has an order of Nystatin powder twice daily, but she has not applied it yet. On 9/3/25 at 10:41AM, Reviewed R2's medical records with V4 Wound Care Nurse. V4 said that R2 's Braden scale…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to conduct a PASARR (pre-admission screening and resident review) for residents in the facility for a mental disorder or related condition prior to being admitted and failed to ensure residents identified with a mental disorder or related condition were evaluated and provided care in the most appropriate setting for 4 (R2, R4, R7, and R25) of 6 residents reviewed for PASARR screening. Findings include: R2 is [AGE] years of age. R2's medical diagnoses include but are not limited to Dementia diagnosed 6/14/24, Schizoaffective disorder upon admission, Major Depressive Disorder upon admission, and Anxiety upon admission. R2's comprehensive assessment dated [DATE] section C cognitive patterns documents a brief interview for mental status with a score of 11 out of 15. A score of 8-12 indicates R2 has moderate cognitive impairment. On 05/07/25 at 1:14 PM, V10 Admissions Director was inquired of R2's PASARR screening. V10 said, I just started a year ago. I know…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to assess pressure ulcer for 1 (R105) of 4 residents reviewed for pressure ulcers in a sample of 50. Findings include: R105 is an [AGE] year-old resident admitted to the facility on [DATE] with diagnoses including but not limited to: congested heart failure, atrial fibrillation, and osteomyelitis of the vertebral, sacral, and sacrococcygeal region. On the (MDS) Minimal Data Set assessment of 4/4/2025, section C, the BIMS (Brief Interviewed Mental Status) score was 11/15 and indicates moderate cognitive impairment. On MDS of 4/4/2025, GG section R105 requires partial/moderate assistance - Helper does less than half the effort. The helper lifts, holds, or supports the trunk or limbs, but provides less than half the effort. Behavior Section E dated 1/24/205 and 2/10/2025 showed no refusal care behavior. On 5/5/2025 at 10:36 AM, R105 was observed in his room, upset because staff members just told him that he had to go to the hospital to treat his buttocks…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review the facility failed to ensure soiled linens were handled in a manner to prevent cross contamination, and failed to ensure incontinence care was completed in a manner to prevent contamination for 1 of 3 residents (R1) reviewed for infection control in the sample of 3. The findings include: R1's admission sheet shows he was admitted to the facility on [DATE] with multiple diagnoses. His 7/24/24 facility assessment and care screening documents him to be cognitively intact. The same document shows R1 has a colostomy and to always be incontinent of urine. The functional assessment shows R1 requires substantial to maximal assistance to roll side to side, sit up, and to transfer between surfaces. On 10/12/24 at 9:30 AM, R1 was observed lying in bed wearing a hospital gown, and an incontinence brief. V4 CNA (Certified Nursing Assistant) entered the room and removed the top sheet. V4 removed R1's incontinence brief, and V5 CNA assisted her with positioning. R1's scrotum…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview, and record review the facility failed to follow the Kitchen Policy by not labeling and dating a package of pita bread and a bulk bag of Indian (Baking) Flour. This failure has the capacity to affect 131 residents with an oral diet. The facility also failed to follow Sanitizer Manufacturer Instructions and Procedures for 3 Compartment Sinks by not immersing blender items for one minute. This failure has the capacity to affect 13 residents on a puree diet. Findings include: On 6-4-24 at 8:00 AM, surveyor observed walk-in refrigerator and noted pita bread wrapped in foil. The pita had no label with open/made date and expiration date. On 6-4-24 at 8:08 AM, surveyor observed dry food storage and noted an (opened) bag of Indian flour with no label with open date or expiration date. On 6-4-24 at 8:08 AM, V11 (Dietary Manager) said all food should be dated with open date and expiration date. V11 said the open date determines how long the food can be used. V11 said he will remove the pita bread and the Indian flour. Kitchen Policy dated 7-23-23 documents: e.…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview, and record review the facility failed to follow the Statement of Resident Rights when a resident was left exposed showing his bare chest and legs visible from the hallway. This failure affected one resident (R86) reviewed for privacy in a total sample of 26. Findings include: On 06/04/24 at 05:56 AM, R86 was observed with his bare chest and legs exposed in his wheelchair from the hallway while V12 (Certified Nurse Aide) was observed changing the linen on R86's bed. On 06/04/24 at 05:59 AM, R86 said he prefers his door closed when changing and does not want to be exposed to the public. On 06/05/24 at 01:07 PM, V2 (Director of Nursing) stated staff should use the privacy curtain or close the door for privacy. On 06/04/24 at 06:00 AM, V12 (Certified Nursing Assistant) said staff should close the door or use the privacy curtain when changing a resident to ensure privacy. On 06/04/24 at 06:22 AM, R60 said R86 was exposed and visible from across the hallway. On 06/06/24 at 02:32 PM, V14 (Social Service Director) said she was told by V1 (Administrator) R86…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview and record review the facility failed to follow controlled medications count policy by failing to maintain an accurate count of schedule II controlled pain medication for 1 of 85 (R129) residents during the medication storage and labeling task. This failure has a potential to affect all 133 residents residing at the facility. Findings include: On 5/15/23 at 9:45 AM, V1 (Administrator) presented survey team with facility matrix showing 133 current residents. On 05/16/23 at 10:19 AM Surveyor conducted inspection of Unit C medication cart. R129's oxyCODONE HCl Oral Solution 5 MG/5ML (Oxycodone HCl) bottle - surveyor observed about half an inch of medication at the bottom of the bottle. Per R129's controlled drug administration record for schedule II controlled medication, last signed out amount on 05/07/2023 by V18 (Licensed Practical Nurse) was 165.5 milliliters. Surveyor requested V18 (LPN) to measure remaining schedule II controlled medication in the bottle; measured amount of remaining medication in the bottle was 16 milliliters; 149.5 milliliters…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview and record review, the facility failed to follow pharmacy medication storage and labeling policy and facility medication pass policy by not noting and implementing open date labels and failing to refrigerate new medication requiring refrigeration before opening. This applies to 6 of 85 (R22, R27, R61, R70, R76, and R121) residents' medications in three of five medication carts and one of one medication storage rooms during the medication storage and labeling task. Findings Include: On 05/16/23 at 10:10 AM Surveyor conducted inspection of the facility medication storage room. Surveyor observed opened and undated medication for: R61 - Ozempic (0.25 or 0.5 MG/DOSE) Subcutaneous Solution Pen-injector 2 MG/3ML (Semaglutide) - no open date On 05/16/23 at 10:19 AM Surveyor conducted inspection of Unit C medication cart. Surveyor observed opened and undated medications for: R22 - Breo Ellipta Aerosol Powder Breath Activated 100-25 MCG/INH (Fluticasone Furoate-Vilanterol) - no open date R61 - HumaLOG Solution 100 UNIT/ML (Insulin Lispro) - no open date R76 -…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.