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| Deficiency Category | Inspection Date: 5/14/24 Complaint Reporting Period: 4/1/24 - 3/31/25 | Inspection Date: 4/11/23 Complaint Reporting Period: 4/1/23 - 3/31/24 | Inspection Date: 3/3/21 Complaint Reporting Period: 4/1/22 - 3/31/23 |
|---|---|---|---|
| Emergency Preparedness Deficiencies | |||
| Automatic Sprinkler Systems Deficiencies | |||
| Building Construction Deficiencies | |||
| Services Deficiencies | |||
| Corridor Walls and Doors Deficiencies | |||
| Egress Deficiencies | |||
| Electrical Deficiencies | |||
| Emergency Plans and Fire Drills Deficiencies | |||
| Fire Alarm Systems Deficiencies | |||
| Smoke Deficiencies | |||
| Interior Finish Deficiencies | |||
| Gas, Vacuum, and Electrical Systems Deficiencies | |||
| Hazardous Area Deficiencies | |||
| Illumination and Emergency Power Deficiencies | |||
| Laboratories Deficiencies | |||
| Medical Gases and Anesthetizing Areas Deficiencies | |||
| Smoking Regulations Deficiencies | |||
| Miscellaneous Deficiencies |
| Total number of Fire Safety & Emergency Preparedness Deficiencies for this nursing home: | |
| Average number of Fire Safety & Emergency Preparedness Deficiencies in Illinois: | |
| Average number of Fire Safety & Emergency Preparedness Deficiencies in the United States: |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Develop and maintain an Emergency Preparedness Program (EP). | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
Develop Emergency Preparedness policies and procedures. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
Establish roles under a Waiver declared by secretary. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
Establish emergency prep training and testing. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
Conduct testing and exercise requirements. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
| No Automatic Sprinkler Systems Deficiencies were found during this inspection period. |
| No Building Construction Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | 5/14/24 | 8/30/24 | 2 - Minimal harm or potential for actual harm | Many |
| No Corridor Walls and Doors Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Have stairways and smokeproof enclosures used as exits that meet safety requirements. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Some |
Install proper backup exit lighting. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
| No Electrical Deficiencies were found during this inspection period. |
| No Emergency Plans and Fire Drills Deficiencies were found during this inspection period. |
| No Fire Alarm Systems Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Have an alternate power supply for its alarm system. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Some |
Provide properly protected cooking facilities. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Some |
Have approved installation, maintenance and testing program for fire alarm systems. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
Install an approved automatic sprinkler system. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
Inspect, test, and maintain automatic sprinkler systems. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
Properly select, install, inspect, or maintain portable fire extinguishes. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
| No Interior Finish Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Some |
Have generator or other power source capable of supplying service within 10 seconds. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
Ensure proper usage of power strips and extension cords. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
| No Hazardous Area Deficiencies were found during this inspection period. |
| No Illumination and Emergency Power Deficiencies were found during this inspection period. |
| No Laboratories Deficiencies were found during this inspection period. |
| No Medical Gases and Anesthetizing Areas Deficiencies were found during this inspection period. |
| No Smoking Regulations Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Have simulated fire drills held at unexpected times. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
To conduct inspection, testing and maintenance of fire doors by qualified individuals. | 5/14/24 | 6/13/24 | 2 - Minimal harm or potential for actual harm | Many |
| Total number of Fire Safety & Emergency Preparedness Deficiencies for this nursing home: | |
| Average number of Fire Safety & Emergency Preparedness Deficiencies in Illinois: | |
| Average number of Fire Safety & Emergency Preparedness Deficiencies in the United States: |
| No Emergency Preparedness Deficiencies were found during this inspection period. |
| No Automatic Sprinkler Systems Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Install a two-hour-resistant firewall separation. | 4/11/23 | 5/8/23 | 2 - Minimal harm or potential for actual harm | Some |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Have properly installed electrical wiring and gas equipment. | 4/11/23 | 5/2/23 | 2 - Minimal harm or potential for actual harm | Some |
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | 4/11/23 | 4/11/23 | 2 - Minimal harm or potential for actual harm | Many |
Have elevators that firefighters can control in the event of a fire. | 4/11/23 | 4/11/23 | 2 - Minimal harm or potential for actual harm | Many |
| No Corridor Walls and Doors Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Have stairways and smokeproof enclosures used as exits that meet safety requirements. | 4/11/23 | 5/8/23 | 2 - Minimal harm or potential for actual harm | Some |
Install emergency lighting that can last at least 1 1/2 hours. | 4/11/23 | 5/8/23 | 2 - Minimal harm or potential for actual harm | Many |
Have properly located and lighted "Exit" signs. | 4/11/23 | 4/11/23 | 2 - Minimal harm or potential for actual harm | Many |
| No Electrical Deficiencies were found during this inspection period. |
| No Emergency Plans and Fire Drills Deficiencies were found during this inspection period. |
| No Fire Alarm Systems Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. | 4/11/23 | 5/8/23 | 2 - Minimal harm or potential for actual harm | Few |
Provide properly protected cooking facilities. | 4/11/23 | 4/11/23 | 2 - Minimal harm or potential for actual harm | Few |
Install a fire alarm system that can be heard throughout the facility. | 4/11/23 | 5/8/23 | 2 - Minimal harm or potential for actual harm | Few |
Install an approved automatic sprinkler system. | 4/11/23 | 5/8/23 | 2 - Minimal harm or potential for actual harm | Few |
Inspect, test, and maintain automatic sprinkler systems. | 4/11/23 | 5/8/23 | 2 - Minimal harm or potential for actual harm | Many |
Install corridor and hallway doors that block smoke. | 4/11/23 | 5/8/23 | 2 - Minimal harm or potential for actual harm | Some |
| No Interior Finish Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Have proper power supply for life support equipment. | 4/11/23 | 5/8/23 | 2 - Minimal harm or potential for actual harm | Many |
Have generator or other power source capable of supplying service within 10 seconds. | 4/11/23 | 5/8/23 | 2 - Minimal harm or potential for actual harm | Many |
Have proper medical gas storage and administration areas. | 4/11/23 | 5/8/23 | 2 - Minimal harm or potential for actual harm | Some |
| No Hazardous Area Deficiencies were found during this inspection period. |
| No Illumination and Emergency Power Deficiencies were found during this inspection period. |
| No Laboratories Deficiencies were found during this inspection period. |
| No Medical Gases and Anesthetizing Areas Deficiencies were found during this inspection period. |
| No Smoking Regulations Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Have simulated fire drills held at unexpected times. | 4/11/23 | 5/5/23 | 2 - Minimal harm or potential for actual harm | Many |
| Total number of Fire Safety & Emergency Preparedness Deficiencies for this nursing home: | |
| Average number of Fire Safety & Emergency Preparedness Deficiencies in Illinois: | |
| Average number of Fire Safety & Emergency Preparedness Deficiencies in the United States: |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Conduct risk assessment and an All-Hazards approach. | 3/3/21 | 4/9/21 | 2 - Minimal harm or potential for actual harm | Many |
Establish policies and procedures for sheltering. | 3/3/21 | 4/9/21 | 2 - Minimal harm or potential for actual harm | Many |
Establish policies and procedures including evacuation. | 3/3/21 | 4/9/21 | 2 - Minimal harm or potential for actual harm | Many |
Provide a means of sharing information on occupancy/needs. | 3/3/21 | 4/9/21 | 2 - Minimal harm or potential for actual harm | Many |
Establish emergency prep training and testing. | 3/3/21 | 4/9/21 | 2 - Minimal harm or potential for actual harm | Many |
Establish staff and initial training requirements. | 3/3/21 | 4/9/21 | 2 - Minimal harm or potential for actual harm | Many |
Conduct testing and exercise requirements. | 3/3/21 | 4/9/21 | 2 - Minimal harm or potential for actual harm | Many |
Implement emergency and standby power systems. | 3/3/21 | 4/9/21 | 2 - Minimal harm or potential for actual harm | Many |
Address patient/client population and determine types of services needed. | 3/3/21 | 4/9/21 | 2 - Minimal harm or potential for actual harm | Many |
Address subsistence needs for staff and patients. | 3/3/21 | 4/9/21 | 2 - Minimal harm or potential for actual harm | Many |
| No Automatic Sprinkler Systems Deficiencies were found during this inspection period. |
| No Building Construction Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. | 3/3/21 | 4/7/21 | 2 - Minimal harm or potential for actual harm | Many |
| No Corridor Walls and Doors Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Keep aisles, corridors, and exits free of obstruction in case of emergency. | 3/3/21 | 3/31/21 | 2 - Minimal harm or potential for actual harm | Some |
Have stairways and smokeproof enclosures used as exits that meet safety requirements. | 3/3/21 | 3/31/21 | 2 - Minimal harm or potential for actual harm | Some |
| No Electrical Deficiencies were found during this inspection period. |
| No Emergency Plans and Fire Drills Deficiencies were found during this inspection period. |
| No Fire Alarm Systems Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Follow proper procedures when the fire alarm was out of service for more than 4 hours. | 3/3/21 | 3/31/21 | 2 - Minimal harm or potential for actual harm | Many |
Inspect, test, and maintain automatic sprinkler systems. | 3/3/21 | 3/31/21 | 2 - Minimal harm or potential for actual harm | Many |
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. | 3/3/21 | 3/31/21 | 2 - Minimal harm or potential for actual harm | Many |
| No Interior Finish Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Have generator or other power source capable of supplying service within 10 seconds. | 3/3/21 | 3/31/21 | 2 - Minimal harm or potential for actual harm | Many |
| No Hazardous Area Deficiencies were found during this inspection period. |
| No Illumination and Emergency Power Deficiencies were found during this inspection period. |
| No Laboratories Deficiencies were found during this inspection period. |
| No Medical Gases and Anesthetizing Areas Deficiencies were found during this inspection period. |
| No Smoking Regulations Deficiencies were found during this inspection period. |
| Inspectors determined that the nursing home failed to: | Inspection Date | Date of Correction | Level of Harm (Least to most) | Residents Affected (Few, Some, Many) |
|---|---|---|---|---|
Have simulated fire drills held at unexpected times. | 3/3/21 | 3/31/21 | 2 - Minimal harm or potential for actual harm | Many |
| This nursing home has not been cited for any deficiencies from incidents reported by the nursing home or complaints in the last 3 years. |