Inspection Reports for Stillwater Senior Living, LLC
1111 University Drive, Edwardsville, IL, 62025
Back to Facility ProfileInspection Report Summary
The most recent inspection on June 3, 2025, identified deficiencies related to medication supervision and inaccuracies in resident service plans. Earlier inspections were generally clean, with no deficiencies noted in surveys conducted in March and April 2025, and compliance confirmed in late 2024. The main issues involved medication administration errors, including missed doses of an antibiotic, and communication problems affecting medication packaging and service plan accuracy. A complaint investigation on June 3, 2025, was substantiated regarding medication supervision failures, while prior complaint investigations were either substantiated without violations or found the facility in compliance. The record shows a recent emergence of medication-related deficiencies following a period of compliance, indicating areas needing focused improvement.
Deficiencies (last 2 years)
Deficiencies (over 2 years)
2 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
43% better than Illinois average
Illinois average: 3.5 deficiencies/yearDeficiencies per year
4
3
2
1
0
Inspection Report
Complaint Investigation
Deficiencies: 2
Date: Jun 3, 2025
Visit Reason
The inspection was conducted following substantiated facility reported incidents on 5-16-25 and 5-25-25, specifically investigating medication administration and supervision related to a complaint that a resident (R2) did not receive a newly ordered antibiotic.
Complaint Details
The complaint investigation was substantiated. Facility reported incidents on 5-16-25 and 5-25-25 were substantiated with violations cited related to medication supervision and administration failures.
Findings
The facility failed to ensure that resident R2 received medication supervision for a newly ordered antibiotic, resulting in R2 missing 9 doses of the antibiotic and prolonging treatment of a Urinary Tract Infection. The failure was due to lack of communication and medication reminder updates for Wellness Partners supervising medication administration.
Deficiencies (2)
Failed to ensure resident received medication supervision of a newly ordered antibiotic, resulting in missed doses and prolonged treatment of Urinary Tract Infection.
Failed to provide medication reminders and supervision of self-administered medication as required, causing substantial probability of harm to the resident.
Report Facts
Missed antibiotic doses: 9
Medication order duration: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| E1 | Executive Director | Confirmed failure in medication communication and supervision causing missed doses for resident R2. |
Inspection Report
Plan of Correction
Deficiencies: 2
Date: Jun 3, 2025
Visit Reason
The document is a post-survey statement of correction related to facility reported incidents IL 193170 and IL193374, addressing violations found during the survey conducted on 6/3/25.
Findings
Two Type 2 violations (295.4010 and 295.500) were identified. The facility provided education to staff, conducted audits of resident service plans, and implemented corrective actions to ensure compliance with medication packaging and service plan updates.
Deficiencies (2)
Violation of 295.4010 related to inaccuracies in resident service plans.
Violation of 295.500 related to medication packaging and communication errors.
Report Facts
Date of Survey: Jun 3, 2025
Date of Education Provided: Jun 2, 2025
Date of Audit: Jun 5, 2025
Date of Medication Education: May 26, 2025
Date of Medication Error Education: Jun 4, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Emily Bruegge-Klein | Executive Director | Met with management and nursing team post survey and provided education |
Inspection Report
Deficiencies: 0
Date: Apr 18, 2025
Visit Reason
The inspection was conducted as a facility reported incident investigation related to an incident report dated 2025-04-12.
Findings
Stillwater Senior Living was found to be in general compliance with the Requirements of the Assisted Living and Shared Housing Establishment Code for this survey.
Inspection Report
Annual Inspection
Deficiencies: 0
Date: Mar 13, 2025
Visit Reason
Annual Licensure Survey conducted to assess compliance with the Assisted Living and Shared Housing Establishment Code.
Findings
Stillwater Senior Living is in general compliance with the requirements of the Assisted Living and Shared Housing Establishment Code for this survey. No deficiencies were cited.
Inspection Report
Deficiencies: 0
Date: Nov 20, 2024
Visit Reason
The survey was conducted as a facility report incident investigation related to an incident dated 11/13/24 with reference IL181139.
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.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Oct 18, 2024
Visit Reason
The report documents a plan of correction following a survey of the assisted living facility to assess compliance with the Assisted Living and Shared Housing Establishment Code.
Findings
The report states that the facility is in general compliance with the applicable code and that the report is substantiated but no violations were cited.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Aug 2, 2024
Visit Reason
The inspection was conducted as a complaint investigation to determine compliance with the Assisted Living and Shared Housing Establishment Code.
Complaint Details
Report substantiated; however, no violations cited.
Findings
The report was substantiated but no violations were cited. The facility was found to be in general compliance with the applicable code for this survey.
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