Inspection Reports for
Ascension Living Bethlehem Woods Village
1571 Ogden Ave, La Grange Park, IL 60526, IL, 60526
Back to Facility Profile4 Reports
Inspection Report — Oct 14, 2025
Annual Inspection
Date: Oct 14, 2025
Visit Reason
Annual Licensure Survey and Facility Reported Incident - IL198010/FRI 9.21.25
Complaint Details
Facility Reported Incident - IL198010/FRI 9.21.25 cited for 295.4010 a) c) d) e) g) 1) 2) 3).
Findings
The establishment was found to have multiple deficiencies including failure to orient residents to emergency plans, incomplete service plan documentation and signatures, and inadequate dementia-specific staff training.
Deficiencies (3)
A2040 (295.2040 Disaster Preparedness) - The establishment failed to orient 5 of 5 residents to emergency and evacuation plans within 10 days of move-in, conduct six fire drills including evening and night shifts, and conduct the required tornado drills on each shift during February 2025.
A4010 (295.4010 Service Plan) - The establishment failed to ensure service plans were signed and dated timely by all involved for 5 of 5 residents and failed to review and revise service plans immediately after significant changes for 4 of 5 residents with falls and injuries.
A4060 (295.4060 Alzheimer's and Dementia Programs) - The establishment failed to ensure three newly hired direct care employees completed the required 4 hours of dementia-specific orientation prior to unsupervised job duties and failed to ensure five newly hired direct care employees completed 16 hours of on-the-job supervision and training within the first 16 hours of employment.
Report Facts
Residents affected: 5
Residents affected: 5
Residents affected: 4
Employees affected: 3
Employees affected: 5
Inspection Report — May 23, 2025
Complaint Investigation
Date: May 23, 2025
Visit Reason
Facility Reported Incident Investigation Survey of 4/30/25 IL191891- 295.4010d)e) cited.
Complaint Details
Facility Reported Incident Investigation Survey of 4/30/25 IL191891- 295.4010d)e) cited.
Findings
The establishment failed to implement fall prevention interventions and did not update service plans annually or after falls for three residents at risk for falls.
Deficiencies (1)
A4010 (295.4010 Service Plan) - The establishment failed to implement fall prevention interventions for a resident at risk for falls and failed to update service plans annually and after a fall for 3 of 3 residents reviewed.
Report Facts
Residents affected: 3
Inspection Report — Aug 23, 2024
Annual Inspection
Date: Aug 23, 2024
Visit Reason
Annual Licensure Survey
Findings
The establishment failed to transfer or discharge one resident requiring total assistance with 2 or more ADLs and more than minimal assistance in emergencies. The facility also failed to ensure fire extinguisher training for 8 newly hired employees and did not report or track a scabies infestation involving 4 residents.
Deficiencies (3)
A2000 (295.2000 Residency Requirements) - The establishment failed to transfer or discharge one resident who requires total assistance with 2 or more activities of daily living and more than minimal assistance in moving to a safe area in an emergency out of 7 residents reviewed.
A2040 (295.2040 Disaster Preparedness) - The establishment failed to ensure that 8 of 8 newly hired employees reviewed completed training and are familiar with the use of fire extinguishers.
A4040 (295.4040 Communicable Disease Policies) - The establishment failed to inform the Illinois Department of Public Health of a scabies infestation involving 4 residents and failed to investigate, track, and document the infestation.
Report Facts
Residents affected: 1
Employees affected: 8
Residents affected: 4
Residents reviewed: 7
Inspection Report — Aug 23, 2024
Complaint Investigation
Date: Aug 23, 2024
Visit Reason
Complaint Investigation Survey: #173844-Substantiated
Complaint Details
Complaint #173844: Substantiated.
Findings
The establishment failed to ensure service plans were reviewed, revised, and signed as required for multiple residents. The plans lacked interventions for falls, behavioral issues, scabies treatment, isolation precautions, and catheter care.
Deficiencies (1)
A4010 (295.4010 Service Plan) - The establishment failed to ensure the service plan was reviewed and revised after significant changes, signed by all involved, and included necessary interventions for seven residents with issues including falls, behavioral problems, scabies treatment, and isolation precautions.
Report Facts
Residents affected: 7
Resident ages: 93
Resident ages: 90
Resident ages: 89
Resident age: 85
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