Gibson Community Hsp Annex
430 East 19th, Gibson City, IL 60936 · Non profit - Corporation · 16 certified beds · (217) 784-2566 Medicare & Medicaid certified
This home has serious findings on its record. Read them closely before you consider it.
- a strong health-inspection score (5/5) — the hardest rating to game (though it’s ranked within its own state, not nationally)
- a high payroll-based staffing rating (5/5)
- lower-than-typical staff turnover (23% vs 45% nationally) — better care continuity
- fewer deficiencies at its most recent standard inspection than at the one before — a sign of improvement
- inspectors cited 1 immediate-jeopardy problem — the most serious level
- the CMS record shows $20,046 in federal fines (most recent 2024-03-13)
One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.
A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.
| Health inspectionSurveyor-assigned, ranked within your stateInspector-verified | 5 of 5 |
| StaffingFrom payroll records (PBJ) | 5 of 5 |
| Quality measuresSelf-reported by the facility | 4 of 5 |
Location & what’s nearby
Open in Google Maps ↗ · Directions ↗ · Larger map ↗
Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.
Quality measures — how residents actually fare
| Overall quality measures | 4 of 5 |
| Long-stay residentspeople who live here | 4 of 5 |
Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.
Trend — is this home getting better or worse?
Over 2025-02 to 2026-06, this home’s CMS overall rating improved from 3 to 5 stars. From monthly CMS archive snapshots.
Horizontal axis runs 2025-02 to 2026-06. That is where CMS’s monthly archive ends, so the right-hand edge of each line is that month — not today.
See all quality measures vs. state & national benchmarks
| Measure | This home | State avg | Typical state | vs typical state |
|---|---|---|---|---|
| Long-stay residents whose need for help with daily activities increased | 10.0% | 13.4% | 15.4% | better |
| Long-stay residents who lose too much weight | 3.0% | 6.3% | 5.4% | better |
| Long-stay residents with a catheter left in their bladder | 3.9% | 0.9% | 0.9% | worse |
| Long-stay residents with a urinary tract infection | 2.5% | 1.5% | 2.0% | worse |
| Long-stay residents with depressive symptoms | 0.0% | 54.2% | 6.5% | check this* — see note marked star below the table |
| Long-stay residents who were physically restrained | 0.0% | 0.1% | 0.1% | better |
| Long-stay residents with falls causing major injury | 0.0% | 3.1% | 3.3% | check this* — see note marked star below the table |
| Long-stay residents whose ability to walk worsened | 3.8% | 14.3% | 16.1% | better |
| Long-stay residents on antianxiety or hypnotic medication | 15.2% | 18.3% | 18.9% | better |
| Long-stay residents with pressure ulcers | 0.0% | 4.8% | 4.7% | check this* — see note marked star below the table |
| Long-stay residents with worsening bladder/bowel control | 33.6% | 20.6% | 21.2% | worse |
| Long-stay residents who got an antipsychotic medication§ — see the note below the table | 0.0% | 21.7% | 17.1% | check this* — see note marked star below the table |
| Short-stay residents who newly got an antipsychotic medication | 0.0% | 2.2% | 1.4% | better |
| Short-stay residents given the seasonal flu vaccine | 40.0% | 63.1% | 79.4% | worse |
* This home reported 0% on a measure where lower is better. That can mean genuinely excellent care — but because the number is self-reported, a zero can also mean the problem was not recorded. Weigh it against the inspection record above.
§ Antipsychotics carry an FDA boxed warning — they raise the risk of death in older people with dementia-related psychosis, and are not approved for that use. So this measure is partly a read on whether a home sedates residents instead of staffing for them. But read a low rate carefully in both directions: CMS excludes residents coded with schizophrenia (and Tourette's or Huntington's) from this measure, and federal auditors have found implausible increases in schizophrenia coding since the measure was published — so a very low rate can reflect recoding rather than less prescribing. Ask the home what share of its residents carry a schizophrenia diagnosis, and how it handles behavioral symptoms without medication.
CMS quality measures, as Care Compare shows them. For most rows lower is better (fewer falls, ulcers, hospitalizations); vaccination rates are the exception. Not every row is risk-adjusted. CMS adjusts some measures for resident mix, but falls with major injury, antipsychotic use, physical restraints and the vaccination rates are unadjusted rates — so a home caring for heavier or more behaviorally complex residents can look worse on them without providing worse care. The “typical state” column is the median of the 50 state averages — not a national average of all homes. We use it because a plain average across homes is pulled badly off course by a few states’ reporting habits (long-stay depressive symptoms is the clearest case: Illinois codes it several times higher than most states, which alone lifted the all-homes figure to about twice what a typical state records). The median of state averages resists that — but it does weigh every state equally, so a large state counts no more than a small one, and it is a benchmark of our construction rather than a CMS-published figure. better/worse means the home differs from that benchmark by more than 10% of it; closer than that reads typical. CMS does not publish how many residents each measure covers, and the counts are often small — a single resident can move a rate by several points — so treat small gaps as noise. These come from data the facility reports, so weigh them against the independent inspection record above.
Short-stay rehab — if you are coming here from a hospital
Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.
35.3% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — CMS rates that worse than the national rate. This is CMS’s risk-adjusted rate over 41 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Therapy staffing: this home’s payroll records show 0.05 therapist hours per resident per day in 2026Q1 — more than 2% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 2% of this home’s weekday level — it runs therapy on weekdays, with essentially none at the weekend. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.
This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.
See every short-stay measure CMS publishes for this home
| Measure | This home | U.S. median | Period covered | CMS’s call |
|---|---|---|---|---|
| Got home and stayed homeRate of successful return to home or community from a SNF | 35.3%CMS range 27.6–47.2 | 51.5% | Oct 2022–Sep 2024 | worse than U.S. |
| Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF | 10.5%CMS range 6.7–16.5 | 10.7% | Oct 2022–Sep 2024 | no different from U.S. |
| Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at discharge | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identified | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care setting | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization | not reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure. | — | ||
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 0.62 | 1.02 | Oct 2022–Sep 2024 | CMS makes no comparison for this measure |
From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.
Staffing
How full it usually is: this home is certified for 16 beds and averages 12.7 residents a day — about 79% occupied, or roughly 3 beds typically open. It usually has some room. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.
Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 4.71 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.78 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.78 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.
Weekend coverage: total nurse staffing is 4.28 hrs/resident/day on weekends vs 4.88 on weekdays — 12% thinner on weekends. RN hours go from 0.89 to 0.51 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
This home’s total nursing-staff turnover of 23% is below the national median of 45%.
Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.
Inspection trend
Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.
Inspection deficiencies
State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.
Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.
11 citations, most serious first — scroll within the box to see all.
- Immediate jeopardy · Jcited before2023-06-05 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review the facility failed to prevent elopement by failing to identify behaviors of wandering/exit seeking and elopement, re-evaluate for risk of elopement, notify the physician and family of exit seeking behaviors, and develop/implement targeted behavior tracking and person-centered interventions to address exit seeking behavior for one resident (R11) reviewed for elopement in the sample list of 14. This failure resulted in R11, a resident with a known history of exit seeking and diagnosis of Dementia, leaving the facility alone and unnoticed by climbing through a window. R11 was found by a member of the community, approximately two tenths of a mile on a residential street/roadway without sidewalks, a state highway and railroad tracks approximately a quarter mile away, wearing dark clothing, while using a walker, by himself(R11) on the side of the road. R11 had the potential for serious injury and/or death of being struck by a motor vehicle or falling. This failure…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Actual harm · Gcited before2024-03-13 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Base on observation, interview and record review, the facility failed to complete a fall risk assessment quarterly and failed to ensure safety equipment was in use during a transfer for one of one residents (R5) reviewed for falls on the sample list of 12. This failure resulted in R5 falling and sustaining a four centimeter laceration requiring seven sutures to the forehead and a fractured humerus. Findings Include: R5's Fall Risk Assessments dated 8/16/23 and 1/29/24 document R5 is a high risk for falls. On 3/12/24 at 10:40 AM, V3 MDS (Minimum Data Set)/CP (Care Plan) Coordinator stated fall risk assessments are to be completed upon admission, with significant changes and quarterly. V3 confirmed R5 only has an August and January assessment completed. V3 is unsure why one was not completed in November stating, that was before my time, but one should have been completed in November 2023. R5's MDS dated [DATE] documents R5 is alert and oriented, and requires substantial/maximal assistance when transferring from a…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · F2024-03-13 · tag F0880 — failed to prevent and control infections — widespreadProvide and implement an infection prevention and control program.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interview and record review the facility failed to maintain complete and current resident and staff infection control logs, analyze infection data to identify trends, restrict staff from working while ill, and test symptomatic staff for COVID-19 (Human Coronavirus Infection). These failures affect eight (R1, R2, R4, R5, R6, R7, R11, R65) of eight residents reviewed for infection control and has the potential to affect all 12 residents in the facility Findings include: 1.) The Employee Illness Reports document the following: On 1/14/24 V20 Certified Nursing Assistant (CNA) called in sick due to sore throat, cough, and muscle aches. On 1/29/24 V12 CNA called in sick due to headache, runny/stuffy nose, body aches, and vomiting. On 2/5/24 and 2/7/24 V18 CNA called in due to headache and vomiting. On 2/6/24 V7 CNA called in sick due to diarrhea and vomiting. On 2/9/24 V9 Licensed Practical Nurse was sent home due to diarrhea and nausea. On 2/16/24 and 2/17/24 V9 called in due to asthma and V9 is taking an antibiotic and steroid. On 2/20/24 V17 CNA called in sick due to vomiting.…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Ecited before2024-03-13 · tag F0881 — failed to use antibiotics responsibly — patternImplement a program that monitors antibiotic use.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interview and record review the facility failed to follow their antimicrobial stewardship policy by failing to accurately document the status of obtaining residents urine cultures and identify/document organisms results. This failure affects five (R1, R2, R4, R5, R6) of eight residents reviewed for infection control in the sample list of 12. Findings include: The facility's Antimicrobial Stewardship policy with reviewed date May 2023 documents the purpose of this program is to ensure appropriate use of antimicrobials which includes selecting the appropriate antibiotic, dose, duration and route to decrease toxicity and antimicrobial resistance. This policy documents to collect, track, and analyze antibiotic use and resistance patterns. This policy documents laboratory personnel will guide the proper use of tests/results and assist in ensuring that laboratory reports will be used to support optimal antibiotic use; and infection control personnel will develop/implement and document facility wide infection surveillance, prevention, and control activities. The January 2024-March…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-03-13 · tag F0641 — isolatedEnsure each resident receives an accurate assessment.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to accurately code a Minimum Data Set for one of 12 residents (R11) reviewed for restraints on the sample list of 12. Findings Include: R11's MDS (Minimum Data Set) dated 1/2/24 documents R11 is alert and oriented, uses bed rails as a restraint daily and is independent with rolling side to side. On 3/11/24 at 9:35 AM, R11 was sitting up in the recliner in R11's room. R11 stated R11 does not use any restraints explaining, I'm able to walk independent down the hall and that R11 uses upper side rails so I (R11) can turn myself in bed. I (R11) want/need them so I (R11) don't have to ask for help. R11's Side Rail assessment dated [DATE] documents R11 uses 1/4 upper rails bilaterally per request to enable in repositioning. R11's Care Plan dated 1/15/24 documents R11 can change positions in bed with assist of one and prefers to use side rails on a daily basis to help with positioning. This care plan also documents R11 has signed the bed rail…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-03-13 · tag F0656 — failed to write and follow a full care plan — isolatedDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interview and record review the facility failed to develop a comprehensive care plan for Urinary Tract Infections (UTI) for one (R1) of twelve residents reviewed for care plans in the sample list of 12. Findings include: On 3/11/24 at 1:08 PM R1 stated R1 gets frequent bladder infections and is not sure what the facility does to prevent them. R1 stated R1 has burning with urination all the time which is a long term problem for R1, and staff assist R1 with toileting. R1's Nursing Notes dated 9/28/23-10/2/23 document R1 was on an antibiotic for a UTI. R1's urine Culture resulted on 1/10/24 documents Escherichia coli (bacteria found in colon) greater than 100,000 colony forming units (CFU), indicating an infection. R1's Urine Culture resulted on 12/30/23 documents Klebsiella pneumoniae greater than 100,000 CFU, indicating an infection. R1's Care Plan revised 2/28/24 does not have a problem, goal, and interventions to address R1's UTIs. On 3/12/24 at 12:00 PM V3 Minimum Data Set Coordinator stated V3 does not care plan for a history of or frequent UTIs, and information such as…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2024-03-13 · tag F0758 — failed to limit and justify psychotropic drugs — isolatedImplement 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.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interview and record review, the facility failed to complete psychotropic medication assessments prior to starting a psychotropic medication and failed to ensure as needed psychotropic medications were limited to 14 days or less for residents. This failure affects three of four residents (R7, R11 and R65) reviewed for unnecessary medications on the sample list of 12. Findings Include: The facility's Psychotropic Medication Policy dated 11/28/17 documents psychotropic medication is any drug that affects brain activity associated with mental processes and behavior. These medications include but are not limited to: antianxiety, antidepressant, antipsychotic and hypnotic. These medications are to be given to treat a specific condition/medical symptom that is diagnoses and documented in the clinical record. Specific condition/medical symptoms alone are not enough to justify pharmacological use. An evaluation must be done to determine other possible physical, mental, behavioral, psychosocial needs. Residents that are admitted with a psychotropic medication need an evaluation by…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-03-13 · tag F0887 — isolatedEducate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review the facility failed to administer a COVID-19 (Human Coronavirus) booster vaccine for one (R2) of five residents reviewed for immunizations in the sample list of 12. Findings include: The facility's COVID-19 Immunization Policy & Procedure - Residents with reviewed date June 2023 documents residents will be offered the vaccine unless it is medically contraindicated or the resident has already been vaccinated. The Centers for Disease Control and Prevention Updated (2023–2024 Formula) COVID-19 Vaccine Interim 2023-2024 COVID-19 Immunization Schedule for Persons 6 Months of Age and Older dated 9/22/23 documents for persons age [AGE] and older administer one does of the 2023-2024 vaccine at least eight weeks after the prior COVID-19 vaccine. R2's undated profile documents R2 is over the age of 65. R2's COVID-19 2023 Vaccine Consent Form dated 1/29/24 documents R2's last COVID-19 booster vaccine was given on 10/20/21, R2 has not had COVID-19 in the last 90 days, and R2 consented to…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Ecited before2023-06-05 · tag F0758 — failed to limit and justify psychotropic drugs — patternImplement 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.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interview and record review the facility failed to attempt Gradual Dose Reductions of psychotropic medications, document clinical rational why dose reductions were not attempted, and care plan nonpharmacological behavioral interventions for four (R4, R8, R9, R11) of five residents reviewed for unnecessary medications in the sample list of 14. Findings include: 1.) R4's Diagnoses List dated 6/1/23 documents R4 has Dementia and Major Depressive Disorder. R4's Physician Order dated 4/25/23 documents administer Lorazepam (antianxiety) 0.5 milligrams (mg) by mouth daily. R4's Physician Order dated 10/27/22 documents to administer Paxil 40 mg by mouth daily. R4's Care Plan dated 4/25/23 documents R4 receives Paxil for depression and symptoms include feeling down and increased fatigue. R4 has anxiety and symptoms include yelling, mocking staff/residents, and throwing items. R4's behaviors also include yelling, hooting, and cussing. This care plan does not include specific nonpharmacological interventions to respond to R4's behaviors. R4's Psychotropic Medication Assessments dated…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-06-05 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolatedProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview the facility failed to treat a Urinary Tract Infection with a positive Urinalysis and confirmed symptoms for one of one residents (R10) reviewed for Urinary Tract Infections in the sample list of 14. Findings include: R10's Face Sheet documents an admission date of 2/24/23 with diagnoses including Unspecified Fracture Upper End of Humerus and Muscle Wasting and Atrophy. R10's Minimum Data Set (MDS) dated [DATE] documents R6 has severe cognitive impairment and documents that R10 is always incontinent of bowel and bladder. R10's Nurse's Notes dated 4/20/2023 at 5:28 PM by V12 Licensed Practical Nurse (LPN) documents (R10) had an unresponsive episode this afternoon. (R10) was sitting in (reclining geriatric chair) with (spouse) by side. When staff was in room checking on (R10), (R10) went unresponsive and eyes rolled back. Spoke with (Nurse at V7's/R10's Physician's office) and made aware of episode. New order received to straight cath (catheterize) resident for UA (Urinalysis)…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2023-06-05 · tag F0881 — failed to use antibiotics responsibly — isolatedImplement a program that monitors antibiotic use.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review the facility failed to ensure for the appropriate use of antibiotics for residents. This failure affects three of four residents (R8, R10, R12) reviewed for antibiotic stewardship in the sample list of 14. Findings include: The facility's Antimicrobial Stewardship Policy and Procedure with a revised date of February 2022 documents, The purpose of this policy is to ensure the proper and safe use of antimicrobials throughout the facility. The objective of the Antimicrobial Stewardship Program will be to improve patient outcomes through optimization of antimicrobial therapy by selection of appropriate antibiotic dose, route and duration of treatment. 1.) R8's Nursing Note dated 05/06/2023 08:07 PM documents R8 returned from the emergency room with a diagnosis of Urinary Tract Infection (UTI) and orders for Amoxicillin (antibiotic) 250 milligrams (mg) by mouth twice daily for 7 days. R8's May 2023 Medication Administration Record documents R8 received Amoxicillin as ordered from…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.
- Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
- Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
- State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Fines & penalties
$20,046 in federal fines across 1 penalty.
- $20,046 — penalty dated 2024-03-13
Dates are the dates CMS records the penalty, not the date of the conduct behind it. CMS publishes penalties on a rolling window, so this is what is currently on the public file — not the home’s lifetime history, and an older fine may attach to a problem that has since been corrected. The amounts are as imposed: the CMS file does not record whether a penalty was appealed, reduced, or paid, so we don’t say. Ask the home what each one was for and what changed since.
Who owns this facility
| Owner / manager | Type | Role | Since |
|---|---|---|---|
| REESE, DONALD | Individual | W-2 MANAGING EMPLOYEE; CORPORATE DIRECTOR | since 02/21/2021 |
| SCHMITT, ROBERT | Individual | W-2 MANAGING EMPLOYEE; CORPORATE OFFICER | since 12/09/2002 |
| BENNETT, KATHLEEN | Individual | CORPORATE DIRECTOR | since 11/01/2010 |
| HUDSON, ANDY | Individual | CORPORATE DIRECTOR | since 10/01/2022 |
| KELLY, STEVEN | Individual | CORPORATE DIRECTOR | since 11/01/2005 |
| LEE, ELLEN | Individual | CORPORATE DIRECTOR | since 11/01/1990 |
| MARTIN, MARGO | Individual | CORPORATE DIRECTOR | since 11/01/1999 |
| NUSS, MARTY | Individual | CORPORATE DIRECTOR | since 11/01/2010 |
| PETERSEN, MIKE | Individual | CORPORATE DIRECTOR | since 03/01/2018 |
| SEYMOUR, KEVIN | Individual | CORPORATE DIRECTOR | since 03/01/2018 |
| STEIDINGER, BRIAN | Individual | CORPORATE DIRECTOR | since 11/16/2016 |
| SWAN, JUSTIN | Individual | CORPORATE DIRECTOR | since 10/01/2022 |
| TAYLOR, JUSTIN | Individual | CORPORATE DIRECTOR | since 03/01/2018 |
| YOUNG, MICHAEL | Individual | CORPORATE DIRECTOR | since 11/01/2001 |
CMS files one row per role, so the 16 rows in the source record cover these 14 parties — each is shown once here with every role it holds. Nothing is omitted. The source lists no ownership percentage for any of them — PECOS records a share only for equity interests, not for board or management roles.
What families pay in IL
This is a Medicare- and Medicaid-certified nursing home, so it can accept Medicaid for long-term care — like nearly all U.S. nursing homes. The private-pay figures below are what families without Medicaid pay; once a resident qualifies for Medicaid, out-of-pocket cost for covered nursing-home care is typically close to $0 (almost all of their income goes to the home as their share of the cost; they keep a small personal needs allowance — for clothing, haircuts, a phone — and Medicaid pays the rest). The amount of that allowance is set by each state. Confirm Medicaid-bed availability with the home, and see the Illinois Medicaid page.
Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.
Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 145979. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-12-10, which can lag current conditions. Staffing hours are CMS PBJ CY2026Q1 (Jan–Mar 2026). Check this record against the government’s own page for it: this home on Medicare Care Compare ↗ — the authoritative source, and the place to confirm anything here before you act on it. How we present it →
Not a government site. Eldercare Lens is not affiliated with, endorsed by, or authorized by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. The star ratings, citations, and inspection wording on this page are reproduced from the public CMS record; the plain-English summaries, tiers, and comparisons around them are ours. We do not speak for CMS, and CMS has not reviewed this page. For the official record, go to Medicare Care Compare. How we’re funded →
Are you this operator? If the record here is out of date, or misses what you have since fixed, tell us and we will look: hello@eldercarelens.com. We reproduce the public CMS record and cannot change what it says — corrections to the underlying data go through CMS and your state survey agency — but we will correct anything we have got wrong about it, and we will say so on the page.