Inspection Reports for Peterson Park Health Care Center

The inspection was conducted to evaluate the facility's pest control program and ensure it effectively prevents and deals with mice, insects, or other pests.

The facility failed to provide and maintain an effective pest control program, with multiple residents reporting and surveyors observing live roaches in various areas of the facility. The maintenance director confirmed past roach sightings and stated that an exterminator visits twice monthly, but residents had not seen recent extermination treatments.

The inspection was conducted due to a complaint investigation regarding an alleged physical abuse incident where resident R5 slapped resident R2 on the face.

The facility failed to protect resident R2 from physical abuse by resident R5, who slapped R2 on the face. The incident was investigated through interviews and assessments, revealing tenderness on R2's face but no discoloration. The allegation of abuse was ultimately not substantiated based on resident and staff interviews.

The complaint involved an allegation of physical abuse where resident R5 slapped resident R2. Interviews with residents and staff indicated that R5 was sleep deprived and frustrated, and the abuse allegation could not be substantiated. R5 admitted to slapping R2 to get him to leave his room, stating he 'lost himself momentarily.'

The inspection was conducted to assess compliance with regulatory requirements related to resident care, safety, infection control, medication management, nutrition, and facility environment.

The facility was found deficient in multiple areas including failure to provide appropriate care for residents with contractures, inadequate supervision and safety measures on the smoking patio, unsecured utility rooms containing sharps and infectious waste, improper care and monitoring of residents with feeding tubes, expired enteral feeding products and medications present, failure to change IV catheter dressings timely, failure to follow pureed diet menus, improper cleaning and sanitizing of kitchen utensils, unlabeled food in resident refrigerators, failure to ensure proper use of call light systems, and failure to ensure contracted staff wore appropriate PPE and proper linen handling.

The inspection was conducted to assess the facility's compliance with federal, state, and local laws and regulations, specifically regarding the scheduling of service plan meetings for the [NAME] Consent Decree Program to transition residents back into the community.

The facility failed to schedule service plan meetings for the [NAME] Consent Decree Program, causing delays in transitioning residents back into the community. Communication issues between the facility and the [NAME] Program representatives were noted, with some emails from the program not receiving responses from the facility's Social Services Director.

The inspection was conducted to investigate complaints related to resident rights violations concerning personal belongings and to assess the care and competency of staff providing feeding tube nutrition and care.

The facility failed to ensure a resident's personal belongings were properly inventoried upon readmission, resulting in a missing gold ring. Additionally, staff unauthorized to operate enteral feeding pumps were observed managing feeding tube care, indicating a failure to follow facility protocols and ensure competent care.

The complaint involved a missing gold ring belonging to resident R1, which was not inventoried upon readmission from the hospital. The facility conducted a search and communicated with the resident's family and legal representatives. Additionally, concerns were raised about unauthorized staff operating a feeding tube pump for resident R2.

The inspection was conducted to assess compliance with sanitary conditions and smoking policies in the facility, including the cleanliness of resident bathrooms and shower rooms, and the management of cigarette odor affecting residents.

The facility failed to maintain sanitary conditions in the shower room and bathrooms on the north wing of the first floor, affecting 46 residents, and failed to provide an environment free of cigarette odor, impacting 55 non-smoking residents on the first floor.

The inspection was conducted to assess compliance with regulatory requirements related to resident dignity, safety, care, medication administration, environment, and facility policies.

The facility was found deficient in multiple areas including failure to maintain resident dignity, inadequate maintenance and housekeeping, failure to provide timely nail and foot care, medication administration errors and documentation issues, improper logging of refrigerator temperatures for resident personal refrigerators, unsanitary shower and bathroom conditions, and failure to control cigarette odor affecting non-smoking residents.

The inspection was conducted due to a complaint investigation regarding the facility's failure to respond timely to a resident's call device and failure to provide showers or bed baths as scheduled for a resident dependent on staff assistance for ADL care.

The facility failed to ensure timely response to a resident's call device for assistance and failed to provide showers or bed baths as scheduled, affecting one resident out of four reviewed. The resident waited over 30 minutes for assistance and received only one shower during the review period despite a twice-weekly shower schedule.

The complaint investigation found that one resident (R1) out of four reviewed was affected by delayed response to call lights and inadequate bathing care. The resident's call device was activated for over 30 minutes without staff response, and the resident received only one shower from 09/01/23 through 10/03/23 despite a twice-weekly shower schedule. The resident is known to refuse showers when in pain but was not offered bed baths or rescheduling.

The inspection was conducted to assess compliance with regulatory requirements related to residents' rights, safe and homelike environment, and accident hazard prevention in the nursing home.

The facility failed to provide and complete admission contracts for three residents upon admission, allowed staff to store personal belongings in a resident's closet, and failed to remove a faulty power cord on a low air loss mattress pump that posed immediate jeopardy to resident safety. The faulty power cord was removed and a corrective plan was implemented.

The inspection was conducted due to a complaint regarding the facility's failure to provide an escort for a resident (R2) during transportation to an outside appointment on 4/15/23.

The facility failed to provide an escort for resident R2 during transportation to a hospital appointment on 4/15/23, despite prior appointments having escorts. The facility's scheduling and communication processes regarding escorts were unclear, and family members confirmed the need for escorts due to R2's physical limitations.

The complaint investigation found that resident R2 was transported to a hospital appointment on 4/15/23 without an escort, contrary to facility policy and family requests. The facility acknowledged the failure and noted gaps in scheduling escorts. Family members confirmed that R2 requires escort assistance due to physical impairments and that no communication was made about the lack of escort on that date.

The inspection was conducted due to complaints and allegations of abuse and communication failures involving residents at Peterson Park Health Care Center.

The facility failed to ensure effective communication interventions for a resident with language barriers and cognitive impairment, failed to prevent resident-to-resident abuse involving multiple residents, and failed to timely and accurately report abuse incidents to the Illinois Department of Public Health (IDPH).

The investigation was triggered by complaints of abuse involving residents R2, R3, and R4. R3 was aggressive and pushed R2 into R4 causing injuries. The facility failed to separate residents appropriately after the incident and failed to report abuse incidents to IDPH within required timeframes. Staff were unaware or failed to report multiple abuse incidents involving R3. The final abuse reports submitted to IDPH did not acknowledge that abuse occurred despite evidence to the contrary.

The inspection was conducted as an annual survey of Peterson Park Health Care Center to assess compliance with regulatory requirements related to resident care, safety, and facility operations.

The facility was found deficient in multiple areas including failure to provide dignity and privacy during care, failure to assess resident ability to self-administer medication, inadequate oral care, improper use and setting of low air loss mattresses, failure to apply restorative devices such as splints, unsecured laundry chute posing a safety hazard, unlabeled oxygen tubing, medication errors, and improper medication storage and labeling.