Deficiencies per Year
4
3
2
1
0
Moderate
Inspection Report
Plan of Correction
Deficiencies: 1
Oct 7, 2025
Visit Reason
The inspection was conducted following a facility-reported incident on 2025-08-19 involving a resident fall with injury, to assess compliance with incident and accident reporting regulations.
Findings
The facility failed to submit an amended incident report after learning that a resident (R3) sustained an orbital fracture following a fall. The initial report was submitted timely but did not include the fracture information, which was known the day after the fall. The facility's policy requires reporting major or serious injuries to the Department of Public Health.
Severity Breakdown
Type 3 Violation: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to submit an amended incident report after a resident sustained a fracture from a fall. | Type 3 Violation |
Report Facts
Residents reviewed for falls: 3
Incident date: Aug 19, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| E8 Licensed Practical Nurse | Licensed Practical Nurse (LPN) | Informed by hospital of resident's injuries |
| E2 Director of Nursing | Director of Nursing | Completed and emailed initial incident report; unaware of need to amend report after fracture was known |
Inspection Report
Complaint Investigation
Deficiencies: 0
May 14, 2025
Visit Reason
Complaint investigation IL00191628 conducted on 5/14/2025.
Findings
The establishment was found to be in compliance with Part 295 Assisted Living and Shared Housing Establishment Administrative Code and 210 ILCS 9/1 Assisted Living and Shared Housing Act.
Complaint Details
Complaint investigation IL00191628 was conducted and the facility was found to be in compliance with applicable assisted living regulations.
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