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Health Inspection Summary
Hawthorne Inn of Danville
3222 Independence Drive
Danville, IL 61832
(217) 431-1600
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Deficiency Category
Inspection Date:
4/17/24
Complaint Reporting Period:
4/1/24 - 3/31/25
Inspection Date:
3/23/23
Complaint Reporting Period:
4/1/23 - 3/31/24
Inspection Date:
1/13/22
Complaint Reporting Period:
4/1/22 - 3/31/23
Freedom from Abuse, Neglect, and Exploitation Deficiencies011
Quality of Life and Care Deficiencies317
Infection Control Deficiencies203
Resident Assessment and Care Planning Deficiencies212
Nursing and Physician Services Deficiencies000
Resident Rights Deficiencies023
Nutrition and Dietary Deficiencies202
Pharmacy Service Deficiencies122
Environmental Deficiencies000
Administration Deficiencies000

Detailed result for inspection on 4/17/24
Date of last standard health inspection:4/17/24Read the full report (PDF)
Date(s) of complaint inspection(s) between 4/1/24 - 3/31/25
No complaint inspections
Date(s) of infection control inspection(s) between 4/1/24 - 3/31/25
No infection control inspections
Total number of Health Deficiencies for this nursing home:10
Average number of Health Deficiencies in Illinois:12.2
Average number of Health Deficiencies in the United States:9.6
Freedom from Abuse, Neglect, and Exploitation Deficiencies
No Freedom from Abuse, Neglect, and Exploitation Deficiencies were found during this inspection period.
Quality of Life and Care Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

4/17/245/8/24
2 - Minimal harm or potential for actual harm
Few

Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.

4/17/245/8/24
2 - Minimal harm or potential for actual harm
Few

Provide safe and appropriate respiratory care for a resident when needed.

4/17/245/8/24
2 - Minimal harm or potential for actual harm
Few
Infection Control Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Implement a program that monitors antibiotic use.

4/17/245/8/24
2 - Minimal harm or potential for actual harm
Few

Develop and implement policies and procedures for flu and pneumonia vaccinations.

4/17/245/8/24
2 - Minimal harm or potential for actual harm
Few
Resident Assessment and Care Planning Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.

4/17/245/8/24
2 - Minimal harm or potential for actual harm
Few

Assure that each resident’s assessment is updated at least once every 3 months.

4/17/245/8/24
2 - Minimal harm or potential for actual harm
Some
Nursing and Physician Services Deficiencies
No Nursing and Physician Services Deficiencies were found during this inspection period.
Resident Rights Deficiencies
No Resident Rights Deficiencies were found during this inspection period.
Nutrition and Dietary Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

4/17/245/8/24
2 - Minimal harm or potential for actual harm
Many

Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

4/17/245/8/24
2 - Minimal harm or potential for actual harm
Many
Pharmacy Service Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

4/17/245/8/24
2 - Minimal harm or potential for actual harm
Few
Environmental Deficiencies
No Environmental Deficiencies were found during this inspection period.
Administration Deficiencies
No Administration Deficiencies were found during this inspection period.

Detailed result for inspection on 3/23/23
Date of last standard health inspection:3/23/23Read the full report (PDF)
Date(s) of complaint inspection(s) between 4/1/23 - 3/31/24
Date(s) of infection control inspection(s) between 4/1/23 - 3/31/24
No infection control inspections
Total number of Health Deficiencies for this nursing home:7
Average number of Health Deficiencies in Illinois:13
Average number of Health Deficiencies in the United States:9.4
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

7/10/237/21/23
2 - Minimal harm or potential for actual harm
Few
Quality of Life and Care Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

3/23/234/18/23
2 - Minimal harm or potential for actual harm
Few
Infection Control Deficiencies
No Infection Control Deficiencies were found during this inspection period.
Resident Assessment and Care Planning Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

5/17/236/5/23
2 - Minimal harm or potential for actual harm
Few
Nursing and Physician Services Deficiencies
No Nursing and Physician Services Deficiencies were found during this inspection period.
Resident Rights Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Keep residents' personal and medical records private and confidential.

3/23/234/18/23
2 - Minimal harm or potential for actual harm
Few

Let each resident or the resident's legal representative access or purchase copies of all the resident's records.

5/17/236/5/23
2 - Minimal harm or potential for actual harm
Few
Nutrition and Dietary Deficiencies
No Nutrition and Dietary Deficiencies were found during this inspection period.
Pharmacy Service Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

5/17/236/5/23
2 - Minimal harm or potential for actual harm
Few

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

7/10/237/21/23
2 - Minimal harm or potential for actual harm
Some
Environmental Deficiencies
No Environmental Deficiencies were found during this inspection period.
Administration Deficiencies
No Administration Deficiencies were found during this inspection period.

Detailed result for inspection on 1/13/22
Date of last standard health inspection:1/13/22Read the full report (PDF)
Date(s) of complaint inspection(s) between 4/1/22 - 3/31/23
Date(s) of infection control inspection(s) between 4/1/22 - 3/31/23
No infection control inspections
Total number of Health Deficiencies for this nursing home:20
Average number of Health Deficiencies in Illinois:12.5
Average number of Health Deficiencies in the United States:8.7
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

1/11/231/31/23
3 - Actual harm
Few
Quality of Life and Care Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

1/13/222/1/22
2 - Minimal harm or potential for actual harm
Few

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

1/13/222/1/22
2 - Minimal harm or potential for actual harm
Few

Provide enough food/fluids to maintain a resident's health.

1/13/222/1/22
2 - Minimal harm or potential for actual harm
Few

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

7/6/227/7/22
2 - Minimal harm or potential for actual harm
Few

Provide care and assistance to perform activities of daily living for any resident who is unable.

1/13/222/1/22
2 - Minimal harm or potential for actual harm
Few

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

7/6/227/7/22
3 - Actual harm
Few

Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.

1/11/231/31/23
2 - Minimal harm or potential for actual harm
Some
Infection Control Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Provide and implement an infection prevention and control program.

1/13/222/1/22
2 - Minimal harm or potential for actual harm
Some

Develop and implement policies and procedures for flu and pneumonia vaccinations.

1/13/222/1/22
2 - Minimal harm or potential for actual harm
Few

Provide and implement an infection prevention and control program.

7/6/227/7/22
2 - Minimal harm or potential for actual harm
Some
Resident Assessment and Care Planning Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

1/13/222/1/22
2 - Minimal harm or potential for actual harm
Some

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

7/6/227/18/22
2 - Minimal harm or potential for actual harm
Few
Nursing and Physician Services Deficiencies
No Nursing and Physician Services Deficiencies were found during this inspection period.
Resident Rights Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

1/13/222/1/22
2 - Minimal harm or potential for actual harm
Few

Reasonably accommodate the needs and preferences of each resident.

1/13/221/31/22
2 - Minimal harm or potential for actual harm
Few

Honor the resident's right to organize and participate in resident/family groups in the facility.

1/13/222/1/22
1 - Potential for minimal harm
Many
Nutrition and Dietary Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

1/13/222/1/22
2 - Minimal harm or potential for actual harm
Many

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

1/13/222/1/22
2 - Minimal harm or potential for actual harm
Some
Pharmacy Service Deficiencies
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

1/13/222/1/22
2 - Minimal harm or potential for actual harm
Some

Ensure medication error rates are not 5 percent or greater.

7/6/227/7/22
2 - Minimal harm or potential for actual harm
Few
Environmental Deficiencies
No Environmental Deficiencies were found during this inspection period.
Administration Deficiencies
No Administration Deficiencies were found during this inspection period.
Complaints and facility-reported incidents in the past 3 years
Inspectors determined that the nursing home failed to:Inspection DateDate of Correction
Level of Harm
(Least to most)
Residents Affected
(Few, Some, Many)

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

7/10/237/21/23
2 - Minimal harm or potential for actual harm
Few

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

5/17/236/5/23
2 - Minimal harm or potential for actual harm
Few

Let each resident or the resident's legal representative access or purchase copies of all the resident's records.

5/17/236/5/23
2 - Minimal harm or potential for actual harm
Few

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

5/17/236/5/23
2 - Minimal harm or potential for actual harm
Few

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

7/10/237/21/23
2 - Minimal harm or potential for actual harm
Some

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

1/11/231/31/23
3 - Actual harm
Few

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

7/6/227/7/22
2 - Minimal harm or potential for actual harm
Few

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

7/6/227/7/22
3 - Actual harm
Few

Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.

1/11/231/31/23
2 - Minimal harm or potential for actual harm
Some

Provide and implement an infection prevention and control program.

7/6/227/7/22
2 - Minimal harm or potential for actual harm
Some

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

7/6/227/18/22
2 - Minimal harm or potential for actual harm
Few

Ensure medication error rates are not 5 percent or greater.

7/6/227/7/22
2 - Minimal harm or potential for actual harm
Few
Infection control inspection deficiencies in the past 3 years
This nursing home has not had any infection control inspections in the past 3 years.
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