1 Report
Inspection Report — Jun 24, 2025
Annual Inspection
Date: Jun 24, 2025
Visit Reason
Annual Licensure Survey. For this survey, the establishment is in compliance with Part 295 Assisted Living and Shared Housing Establishment Administrative Code and 210 ILCS 9/1 Assisted Living and Shared Housing Act.
Findings
The establishment was found in compliance with all applicable regulations during the annual licensure survey.
9 CMS Surveys
Inspection Report — Feb 13, 2025
Date: Feb 13, 2025
Visit Reason
The document does not contain an A 000 Initial Comment block naming the visit type, so inspection_type is set to 'other'.
Findings
The facility failed to ensure safe transfers and proper bed frame adjustment, resulting in a resident sustaining a laceration requiring 18 sutures. The bed frame was wider than the mattress causing injury, and staff did not follow the two-person assist plan of care.
Deficiencies (2)
F0689 (295.2040) - The facility failed to ensure proper staff assistance during transfers, resulting in a resident being transferred by one staff instead of two and sustaining a laceration requiring hospital treatment.
F0909 (295.3000) - The facility failed to ensure the bed frame was properly adjusted to fit the mattress, causing a resident's leg to contact the loose bed frame and sustain a laceration requiring 18 sutures.
Report Facts
Residents affected: 1
Inspection Report — Sep 19, 2024
Annual Inspection
Date: Sep 19, 2024
Visit Reason
Annual Licensure Survey
Findings
The facility was found to have multiple deficiencies including failure to ensure resident dignity with catheter privacy, incomplete controlled substance counts, failure to follow fluid restriction diet orders, improper food labeling and storage, lack of temperature monitoring in residents' personal refrigerators, open garbage dumpster lids, and failure to implement enhanced barrier precautions for a resident with a chronic wound.
Deficiencies (7)
F0550 (295.2050 Resident Rights) - The facility failed to ensure one resident's urinary catheter drainage bag was covered with a privacy cover, affecting one resident in a sample of 44.
F0755 (295.3000 Pharmaceutical Services) - The facility staff failed to complete the controlled substance shift to shift count form, affecting all 43 residents on the first and second floors.
F0803 (295.2040 Therapeutic Diet Orders) - The facility failed to follow a resident's diet order for fluid restriction, affecting one resident out of 44 reviewed.
F0812 (295.3100 Food Safety) - The facility failed to ensure foods were labeled, dated, and maintained to prevent foodborne illness, potentially affecting all residents.
F0813 (295.3100 Food Safety) - The facility failed to maintain temperature logs and provide thermometers for residents' personal refrigerators for two residents, potentially affecting three residents.
F0814 (295.3100 Sanitation) - The facility failed to ensure garbage dumpster lids were closed, potentially affecting all residents.
F0880 (295.6000 Infection Control) - The facility failed to ensure a resident with a chronic wound was placed on Enhanced Barrier Precautions, potentially affecting 27 residents on the second floor.
Report Facts
Residents affected: 1
Residents affected: 43
Residents affected: 1
Residents affected: 3
Residents affected: 27
Inspection Report — Apr 7, 2024
Date: Apr 7, 2024
Visit Reason
The document does not contain an A 000 Initial Comment block specifying the visit type. It is a Statement of Deficiencies for Smith Village dated 04/07/2024.
Findings
The facility failed to provide adequate supervision for one confused resident at high fall risk, resulting in a fall with head injury requiring hospitalization and staples. The facility implemented a fall monitoring sensor system to improve supervision.
Deficiencies (1)
F0689 (Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents) - The facility failed to provide adequate supervision for one confused resident who is a high fall risk, resulting in a fall with head injury and hospitalization.
Report Facts
Residents affected: 1
Inspection Report — Feb 9, 2024
Complaint Investigation
Date: Feb 9, 2024
Visit Reason
Complaint investigation of an elopement incident involving a resident with dementia who left the facility unattended and was found outside in the courtyard.
Complaint Details
Complaint investigation of resident elopement resulting in minimal harm; no other complaints listed.
Findings
The facility failed to adequately supervise a confused resident who eloped from the facility, despite alarms and security measures in place. Staffing shortages and failure to properly respond to alarms contributed to the incident.
Deficiencies (1)
F0689 (295.0689) - The facility failed to supervise and prevent a confused resident from eloping, with staff not properly responding to alarms and security measures, resulting in the resident being found outside unattended.
Report Facts
Residents affected: 1
Residents reviewed: 3
Inspection Report — Oct 20, 2023
Annual Inspection
Date: Oct 20, 2023
Visit Reason
Annual Licensure Survey. For this survey, the establishment was inspected for compliance with Part 295, including resident dignity during meals, respiratory care, food safety, sanitation, infection prevention, and PPE use.
Findings
The facility was found to have multiple deficiencies including failure to maintain residents' dignity during meals, improper respiratory care equipment labeling and storage, unsafe food storage and handling practices, uncovered dumpsters attracting pests, and failure to use proper PPE during medication administration.
Deficiencies (5)
F0550 (295.295.550 Resident Rights) - The facility failed to maintain residents' dignity during meals by not serving meals simultaneously at tables and feeding residents while standing rather than sitting, affecting some residents.
F0695 (295.295.695 Respiratory Care) - The facility failed to label and date oxygen tubing for three residents, improperly stored oxygen tubing and nebulizer equipment, failed to change an oxygen humidifier bottle, and did not post oxygen in use signage for one resident.
F0812 (295.295.812 Food Safety) - The facility failed to properly label, date, and store food items, failed to separate raw and cooked foods correctly, and staff failed to perform appropriate hand hygiene between handling dirty and clean dishes, risking foodborne illness for many residents.
F0814 (295.295.814 Sanitation) - The facility failed to ensure dumpsters were covered and the surrounding area kept clean to prevent pest harborage and feeding, risking infestation affecting all residents.
F0880 (295.295.880 Infection Control) - The facility failed to ensure staff wore proper PPE, specifically a gown, during medication administration for a resident on Enhanced Barrier Precautions, risking infection transmission.
Report Facts
Residents affected: 37
Residents affected: 3
Residents affected: 70
Residents affected: 28
Inspection Report — Aug 23, 2023
Date: Aug 23, 2023
Visit Reason
The document does not contain an A 000 Initial Comment block specifying the visit type; therefore, inspection_type is set to 'other'.
Findings
The facility failed to ensure a resident's call light was within reach, resulting in the resident falling out of bed and sustaining a closed right hip fracture. Multiple staff interviews and record reviews confirmed the call light was not in place, contributing to the fall.
Deficiencies (1)
F0558 (not explicitly stated section, but tag F0558) - The facility failed to reasonably accommodate the needs and preferences of a resident by not ensuring the call light was within reach, resulting in a fall and injury to the resident.
Report Facts
Residents affected: 1
Residents reviewed: 3
Inspection Report — Jun 14, 2023
Date: Jun 14, 2023
Visit Reason
The document does not contain an A 000 Initial Comment block specifying the visit type; therefore, the inspection type is classified as 'other'.
Findings
The facility failed to ensure that a nursing home area was free from accident hazards and did not provide adequate supervision to prevent accidents, specifically failing to properly transfer a resident using a total body mechanical lift machine with the required two staff members.
Deficiencies (1)
F0689 (No Illinois section number) - The facility failed to ensure safe resident handling by transferring a resident with a total body mechanical lift machine without the required two staff members present, risking injury to the resident and staff.
Report Facts
Residents affected: 1
Inspection Report — Apr 20, 2023
Date: Apr 20, 2023
Visit Reason
The document does not contain an A 000 Initial Comment block specifying the visit type. It is a deficiency report for Smith Village dated 04/20/2023.
Findings
The facility failed to conduct timely and adequate skin assessments and showers for multiple residents, resulting in actual harm including a resident requiring surgical intervention for a skin lesion. Several residents' care plans excluded required skin assessments, and documentation was incomplete or missing.
Deficiencies (1)
F0600 (295.6000 Resident Rights) - The facility failed to address a resident's injury of unknown origin, failed to obtain physician orders for weekly skin assessments, failed to conduct bi-weekly showers and skin assessments as scheduled for four residents, failed to document skin integrity impairments, and failed to timely notify the physician of a resident's change in skin condition, resulting in actual harm.
Report Facts
Residents affected: 4
Inspection Report — Dec 8, 2022
Date: Dec 8, 2022
Visit Reason
The document does not contain an A 000 Initial Comment block specifying the visit type; therefore, inspection_type is set to 'other'.
Findings
The facility was found to have multiple deficiencies related to resident rights, fall prevention and supervision, medication and supplement storage, and food storage practices.
Deficiencies (4)
F0578 (Resident Rights) - The facility failed to enter a full code status order under the physician orders in the electronic medical record for one resident (R35) in the sample of 29 residents reviewed for advance directives.
F0689 (Accident Hazards and Supervision) - The facility failed to supervise three cognitively impaired residents at high risk for falls, resulting in repeated falls and injury to one resident (R11) who sustained a 2-centimeter laceration requiring staples and bruising to the right hand.
F0761 (Drugs and Biologicals Storage) - The facility failed to ensure expired dietary supplements were discarded and failed to record daily temperatures of medication and supplement refrigerators as per facility policy, potentially affecting all residents receiving dietary supplements or refrigerated medications.
F0812 (Food Storage) - The facility failed to follow proper food storage practices by storing bread racks directly on the kitchen floor, risking contamination and potential food-borne illnesses affecting all 68 residents receiving oral diets.
Report Facts
Residents affected: 1
Residents affected: 3
Residents affected: 68
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