Based on interviews and record review the facility failed to implement interventions, for R2 to prevent overdose of medication. Faculty was aware R2 had medications in her purse and previously had meds. R2 was being seen by a Psychiatry Nurse Practitioner. R2 had shown a decrease in Mental status and the Psychiatry Nurse Practitioner, nor the Physician was notified. Based on interviews and record review the facility failed to accurately assess, monitor, implement and provide services, for R2's Mental and Psychosocial wellbeing, due to R2 recently sustaining physical abuse, and having major depressive disorder and anxiety. This resulted in R2 overdosing on Xanax and Tylenol. …
F742 citations in Illinois
Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Illinois cites F742 less often than its own record predicts
0.62 times the national share — cited less often here than elsewhere.
Of every deficiency written in Illinois in 2025, this is the portion that was F742.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Illinois surveyors wrote
F742 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 observation, interview, and record review, the facility failed to ensure appropriate behavioral health services were provided for two (R4 and R6) of three residents reviewed for behavioral concerns, when the facility failed to implement effective behavioral health interventions, failed to provide coordinated behavioral health services, and failed to ensure adequate assessment and communication regarding psychotropic medication management. These failures resulted in continued unsafe behaviors and a resident-to-resident physical altercation that caused actual harm (skin tear) to R6.Findings Include:Facility has no Policy on Behavioral ServicesReview of the Electronic Health Record (EHR) revealed R4 had diagnoses including Frontotemporal Neurocognitive Disorder, Dementia with… …
Based on interview and record review the facility failed to implement specific PTSD/Post Traumatic Stress Disorder interventions for one of one (R27) residents reviewed for Post Traumatic Stress Disorder in a sample of 24. Findings include: The facility's Trauma Informed Care policy, undated, documents it is the policy of this facility to provide care and services which, in addition to meeting professional standards, are delivered using approaches which are culturally-competent, account for experiences and preferences, and address the needs of trauma survivors by minimizing triggers and/or re-traumatizing. …
The short window
Recent years
| Year | Share of Illinois citations | vs expected |
|---|---|---|
| 2023 | 0.05% | 0.44× |
| 2024 | 0.06% | 0.47× |
| 2025 | 0.07% | 0.62× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Illinois surveyors cite →
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