Aperion Care Forest Park
APERION CARE FOREST PARK in FOREST PARK, IL — inspection on June 23, 2024.
Found 6 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
On the second floor there was an ice machine with a single push chute for ice dispensing.
This ice
leftovers and grease splatters. V19 said, the ice machine and the microwave are very dirty; I am not
same room had a greasy substance, black and dark brown residue, three small towels noted on top of the counter with yellow and black stains; the floor was observed to be dirty and run-down in appearance; the baseboards noted to be dusty and with black crumbs. V19 said the rooms need to be clean, it is not acceptable to have the rooms dirty.
The third and fourth floor microwave located in the nourishment room, was noted to have crusty paper towels and food splatters inside upon V19 opening the door to the microwave. V19 said, this is so dirty, it should not be like this, it needs to be totally clean.
The room floors were noted to have debris all over and the baseboards were noted to be discolored dirty, and dusty. V19 said, I do not know why the nourishment rooms are so dirty; it is not acceptable. 6/15/2024 at 3:45PM walking rounds were completed with V1 (Administrator).
The ice-cream room was observed with piece of pizza on the floor, tomato paste, black and dark brown residue, and the tables and chairs were noted to be dirty with red, brown, and black marks. A kitchen counter in the same room had brown-black sticky areas, rust on the corners, and a sink with dry, dusty black areas.
V1 (Administrator) said, the room is definitely dirty. I expect the area to be clean. I will call for housekeeping to take care of it. 6/16/2024 at 7:00AM, ice-cream room was noted to be dirty, in the same condition it was previously observed on the previous day (6/15/2024). 6/16/2024 at 8:15AM, R2 said, the housekeeping needs to clean the rooms and the entire building more because they are dirty.
V1 (Administrator) presented an updated policy titled: Housekeeping Guidelines reads: provide guidelines to maintain a safe and sanitary environment for residents, facility staff, and visitors.
145969 06/23/2024
Aperion Care Forest Park 8200 West Roosevelt Road Forest Park, IL 60130
provided. If the patient refuses the nurse needs to be informed.
hemiplegia and hemiparesis following a cerebrovascular disease, diabetes and major depression.
cognitively intact.
Section GG personal hygiene indicates R10 requires substantial/maximal assistance from facility staff.
On 6-16-2024 at 7:45am R10 said, I do not get my showers on the days they are scheduled because the people do not have time. I am a clean person and do not like to miss my showers. My schedule days are Saturdays and Wednesdays.
V14 (Director of Nursing) provided R10's shower sheets. R10's task documentation documents: Activity of Daily Living (ADL), bathing patient Tuesday and Friday Evening shift.
The documentation for April and May 2024 read:4-6-2024, 4-13-2024,4-27-2024, and 5-4-2024 no documentation, area was observed to be blank on the shower sheet.
On 6-16-2024 at 11:00am, V14 (DON) on R10 there is no documentation on the following days: 4-6, 4-13, 4-27-2024, and 5-4-2024 for the showers. I cannot tell you if the showers were given or not, my expectation is that the nursing staff documents according to the showers provided. If the patient refuses the nurse needs to be informed.
V1 presented policy dated: 11-28-12 titled: Bathing-shower and Tub Bath reads: To ensure resident's cleanliness to maintain proper hygiene and dignity.
Document bathing task and assistance provided in the electronic record, including pertinent observations.
145969 06/23/2024
Aperion Care Forest Park 8200 West Roosevelt Road Forest Park, IL 60130
During the monthly Quality Assurance (QA) Meeting, IDT will review ongoing training of nurses, review competencies and review any incidents of Narcan medication administration. QAPI Team, Initiated Date 6/20/24, Ongoing monthly until 6/21/25
- The facility will monitor the next 5 uses of Narcan, up until 6/21/25 to ensure staff follow the
- The facility will randomly competency 3 nurses a week for the next 12 weeks to ensure they are
updated facility policy on substance use. DON and ADON, Initiated Date 6/20/24, Ongoing up until 5 Narcan uses or 6/21/25.
aware of the proper protocol for Narcan administration and substance use.
Competencies will be added to Annual Nursing Competencies.
DON and ADON, Initiated Date 6/20/24, Completion Date 9/19/24 and Ongoing
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Aperion Care Forest Park 8200 West Roosevelt Road Forest Park, IL 60130
can only do what I can do. I know some residents were not attended to last night.
On 6-17-2024 at 12:46pm V1 (Administrator) said, we do not have any staffing policy. V1 presented document [NAME]: facility assessment dated : 1-16-2024 under staffing it reads: Overall staffing: 00 activities of daily living: sufficient.
145969 06/23/2024
Aperion Care Forest Park 8200 West Roosevelt Road Forest Park, IL 60130
resident's needs.
Under Staffing section of Facility Assessment, Overall Staffing Number is 00 and
required to ensure sufficient number of qualified staff are available to meet each resident's needs.
to be noted that the referenced spreadsheet does not include number of staff needed; it only documents sufficient.
During the monthly Quality Assurance (QA) Meeting, IDT will review ongoing training of nurses, review competencies and review any incidents of Narcan medication administration. QAPI Team, Initiated Date [DATE], Ongoing monthly until [DATE]
8.
The facility will monitor the next 5 uses of Narcan, up until [DATE] to ensure staff follow the updated facility policy on substance use. DON and ADON, Initiated Date [DATE], Ongoing up until 5 Narcan uses or [DATE].
9.
The facility will randomly competency 3 nurses a week for the next 12 weeks to ensure they are aware of the proper protocol for Narcan administration and substance use.
Competencies will be added to Annual Nursing Competencies. DON and ADON, Initiated Date [DATE], Completion Date [DATE] and Ongoing
145969
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 145969 B.
Wing 06/23/2024
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Aperion Care Forest Park 8200 West Roosevelt Road Forest Park, IL 60130
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.