Symphony at Aria

Symphony at Aria is a 198-bed nursing home facility in Hillside, IL. Symphony at Aria offers post-acute care and rehabilitation, along with long term care. Their website advertises that their “guests” will feel like they are in a fine hotel, with an emphasis on tranquility, serenity, and comfort. They are “one of the country’s most innovative leaders in post-acute care and management services… working to provide the best possible outcomes for our guests.”

Reality: Symphony at Aria has had 30 complaints that have resulted in a citation in the past three years and has been fined over $10,000 by Medicare in this timeframe. RNs spend a whole 27 minutes per resident at this facility – just over half the Illinois average.

• Facility name: Symphony at Aria
• Facility address: 4600 North Frontage Rd, Hillside, IL, 60162
• Facility phone: (708) 544-9933

03/24/2017 Failure to keep each resident free from physical restraints, unless needed for medical treatment. A resident was observed as calmly laying in their bed, non-combative, alert, but non-verbal; with hand mitten restraints in place. The LPN stated he was admitted with hand mittens, family requested to keep him from removing catheter. There was no record of him attempting to remove catheter or any trails of alternative methods to keep him from removing the catheter.

03/23/2018 Failure to implement gradual dose reductions (GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. Multiple residents were being administered psychotropic medications for mood control and in some cases could be perceived as being used to subdue some patients, with no documented records of attempts at non-pharmacological methods to assist these individuals in most cases.

One resident was on two medications for mood stabilization. She was observed as very calm, coloring as she sat in her wheelchair. She did not interact with other residents, and only interacted with staff when prompted. Her records indicated that she can become physically aggressive with other residents due to dementia, but is easily redirected, which counter indicates her need for mood altering drugs.

Another resident was observed curled up in her bed, extremely lethargic, but making involuntary body movements. Her records indicate that she has been receiving a mood-altering medication via her g-tube. The psychiatric nurse practitioner stated that the medication was to help control her involuntary body movements and helps keep her in her wheelchair or bed as she is a fall risk.

Yet another resident was observed as appearing lonely and depressed. She had been refusing grooming, activities, and had to be coaxed to eat. She was seen later in the day staring into space, seated with a peer, but not interacting. At the time of interview, the Director of Nursing put her on the list for a psych evaluation. He did not have record of how long the resident had been on this medication.

05/03/2018 Failure to provide appropriate treatment and care according to orders, resident’s preferences and goals and provide care and assistance to perform activities of daily living for any resident who is unable. Several residents were observed with dirty, long fingernails and toenails. One resident stated he has asked several times for assistance with nail trimming.

Another resident was observed with undressed wounds including multiple scabs and open skin wounds with dried blood on both of their legs. The response from the nurse was that the resident always scratches her legs. Physicians order indicates the use of skin protectant and dressings for the wounds.

A resident with multiple and significant medical issues requires close monitoring of weight and vital signs, including daily weight checks and vitals checks on each shift. His records indicated that he was only having vital signs checked maybe once a day and occasional weight checks.

03/01/2018 Failure to ensure services provided by the nursing facility meet professional standards of quality. Medicines were observed to be pre-poured on medicine carts of multiple nurses before med pass. Both nurses that were questioned about this practice stated that if they don’t get a jump on medicine pass, they wouldn’t get it done. There isn’t enough help.

The list continues with yet more questionably heavy psychotropic drugs, poor infection control, and poor food safety measures, as well as residents going several hours between continence care.