Based on interview and record review, the facility failed to follow the state Power of Attorney Act when a facility nurse became a resident's Health Care Power of Attorney and the nurse was allowed to continue care for the resident as her nurse at the facility. The facility also allowed a director (Assistant Director of Nursing) to witness the signing of the resident's Health Care Power of Attorney form. This applies to 1 of 3 residents (R1) reviewed for Power of Attorney (POA) in the sample of 5.The findings include:R1's Face Sheet showed diagnoses to including, but not limited to, anxiety, falls, heart failure, and schizophrenia. On 8/18/26 at 10:15 AM, R1 stated she did not know who her doctor was, what month it was, and she did not know the year. …
F551 citations in Illinois
Resident Rights Deficiencies
Give the resident's representative the ability to exercise the resident's rights.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Illinois cites F551 less often than its own record predicts
0.58 times the national share — cited less often here than elsewhere.
Of every deficiency written in Illinois in 2025, this is the portion that was F551.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Illinois surveyors wrote
F551 findings written in Illinois, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on interviews and record review the facility failed to obtain a requested capacity assessment from R1's provider to determine R1's cognitive status. R1 is one of 4 residents reviewed in a sample of 3 for policy and procedures. Findings include: On 12/23/2020 at 2:23 PM V24 (Guardian/Attorney) stated that he has called, emailed and sent faxes to the facility for about a year trying to get a capacity assessment done on R1 in order to determine if R1 had the mental capacity to sign a living will. On 12/23/2020 V24 stated, My notes show that I called on August 28, 2019, and October 25, 2019, leaving messages both time(s). Review of fax from V24 to V2 (Director of Nursing/DON) on 10/25/2020 documents V24 stating that this was his third request to get capacity assessment. …
The short window
Recent years
| Year | Share of Illinois citations | vs expected |
|---|---|---|
| 2024 | 0.05% | 0.61× |
| 2025 | 0.04% | 0.58× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Illinois surveyors cite →
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