Safe, clean, homelike environment · Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
F584 in Illinois. Pick another state for the same tag.
Against expectation — 2025
Illinois cites F584 less often than its own record predicts
Versus expected share1.00×
1.00 times the national share — cited less often here than elsewhere.
Share of Illinois citations2.09%
Of every deficiency written in Illinois in 2025, this is the portion that was F584.
Illinois2.09%
National2.10%
Share of all citations that were F584.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Illinois surveyors wrote
F584 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.
K · Immediate jeopardy, patternAugust 27, 2025
Based on observation, interview and record review the Facility failed to ensure room temperatures were within the heat index/apparent temperature guidelines inside the facility and did not exceed 81 degrees Fahrenheit (F), the Facility failed to follow their Heat Emergency Policy as residents were not moved out of their rooms when temperatures were reached over 81 degrees for 4 of 4 residents (R1, R2, R3 and R11) reviewed for room temperatures in the sample of 16. This failure resulted in residents being left in rooms with the heat index indicating extreme caution to the residents. On 8/27/2025 at 9:55 AM, the Immediate Jeopardy/IJ was called with V1, Administrator. V2, Director of Nursing. …
Based on observation, interview, and record review the facility failed to have effective window safety latches to prevent a resident (R1) with Dementia and at risk for elopement from opening her 3rd floor room window. This failure resulted in R1 exiting through her 3rd floor window. Subsequently, staff observed R1 face down on the ground from her room window. R1 was unresponsive, blood from her face and abdomen on the ground when emergency services arrived. Police records document a death investigation.Findings include:R1's admission date was 6/30/2026. …
E · No harm, potential for more than minimal, patternAugust 28, 2026
Based on observation, interview and record review the facility failed to provide a homelike environment for three (R1, R4, R9) out of three residents reviewed for Resident Rights in a sample list of nine residents.Findings include:1. R1's Minimum Data Set (MDS) dated [DATE] documents R1 as cognitively intact. On 8/25/26 at 11:55 AM R1's floor was missing floor tile pieces. R1's wall surrounding the air conditioning unit showed several inches of blistering paint with a moderate amount of black dots on the paint. R1's walls showed several long scrapes of missing paint. On 8/25/26 at 11:57 AM R1 stated the facility put R1 in this room that is torn up. R1 stated the walls of his room need painted, and the mold should be removed before it makes R1 sick. …
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