Based on interview and record review, the facility failed to accurately complete assessments that identify R3's aggressive behaviors and blindness. These failures resulted in R3 physically assaulting 2 residents (R2 & R7) and causing multiple facial fractures to one resident (R7). These failures caused harm and affected 3 residents (R2, R3, and R7) reviewed for assessment accuracy. Findings include: R3's admission record documents in part that R3 was admitted on [DATE] and had the following active diagnosis: cerebral infarction, cognitive communication deficit, bipolar disorder, other Alzheimer's disease, vascular dementia with other behavioral disturbance, major depressive disorder, unspecified psychosis not due to a substance or a known physiological condition, and legal blindness. …
F641 citations in Illinois
Accuracy of assessments · Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Illinois cites F641 less often than its own record predicts
0.23 times the national share — cited less often here than elsewhere.
Of every deficiency written in Illinois in 2025, this is the portion that was F641.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Illinois surveyors wrote
F641 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 interview and record review, the facility failed to complete assessments accurately and failed to complete the Minimum Data Set accurately in accordance with RAI guidelines. These failures affected four residents (R1, R2, R5, & R6) in a sample of 64. Findings include: 1) R5 is a [AGE] year-old female resident with diagnoses including: Parkinson's disease, type 2 diabetes mellitus, unspecified dementia, schizoaffective disorder, bipolar disorder, autistic disorder, major depressive disorder, anxiety, and cognitive communication deficit. R5's Minimum Data Set (MDS) (6/3/2026) documents R5 used a other physical restraint less than daily in the lookback period, and R5's chair preventing rising was not assessed. …
Based on interview and record review the facility failed to ensure that the Minimum data set (MDS) assessment was recorded with accurate information for 5 of 5 residents (R1, R14, R45, R113 and R18) reviewed for accuracy of MDS.Findings include: 1. R1's MDS dated [DATE], section I for active diagnosis, show psychiatric mood disorders, no is checked for depression. Review of R1's medical diagnosis there are no diagnosis for psychiatric illness. R1's progress notes from psychotherapist denotes diagnosis: generalized anxiety disorder and major depressive disorder, recurrent, moderate. 2. …
The short window
Recent years
| Year | Share of Illinois citations | vs expected |
|---|---|---|
| 2023 | 0.32% | 0.19× |
| 2024 | 0.40% | 0.23× |
| 2025 | 0.42% | 0.23× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Illinois surveyors cite →
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