Amoroso Healthcare and Rehabilitation Woodridge

In the surveyor’s words

From the most serious findings on record at Amoroso Healthcare and Rehabilitation Woodridge, in the surveyor’s own words.

• Immediate jeopardy, patternF689May 12, 2026

  Based on observations, facility policy review, clinical record review, review of facility investigation documentation, and staff interviews, it was determined that the facility failed to implement interventions, supervision, and effective safety measures to prevent elopement of a resident identified as being at risk for elopement (Resident 1). Resident 1 exited the building through an unlocked door and was found in the facility's parking lot. This failure placed eight additional residents in an Immediate Jeopardy situation who were identified as an elopement risk (Residents 2, 3, 4, 5, 6, 7, 8 and 9). […]

• No harm, potential for more than minimal, widespreadF885Jan 6, 2022

  Based on interview and record review it was determined that the facility failed to have a mechanism in place to notify residents, their representatives, or families, regarding COVID 19 status updates including open visitation for nine of thirty-three residents reviewed, Residents (R 23, R39, R 43, R 50, R 54, R 60, R 63, R 72, and R 78). Findings include: A review of Nursing Home Visitation - COVID-19, Ref: QSO-20-39-NH REVISED 11/12/2021, Effective November 12, 2021 Visitation is now allowed for all residents at all times. A review of the clinical record for Resident 60 revealed a Quarterly assessment (periodic review of resident needs) dated December 10, 2021, with a BIMS (brief interview of mental status) score of 13 indicating she is cognitively intact. […]

• No harm, potential for more than minimal, patternF641Nov 26, 2025

  Based on clinical record review and staff interviews, it was determined that the facility failed to ensure the resident assessment accurately reflected the resident condition for six of 19 residents reviewed (Residents 2, 4, 5, 7, 15, and 32).Findings include: Review of Resident 2's clinical record revealed diagnoses that included pressure ulcer of sacral region, stage 4 (injury to the skin and underlying tissue caused by prolonged pressure on the skin), hypertension (persistent high blood pressure), and schizophrenia (a chronic mental health condition characterized by disruptions in thought, perception, and behavior). […]

• No harm, potential for more than minimal, patternF689Nov 26, 2025

  Based on policy review, observations, clinical record review, and staff interviews, it was determined that the facility failed to provide interventions to prevent accidents for two out of 19 residents reviewed (Residents 4 and 83).Findings include: Review of the facility policy, titled Falls - Clinical Protocol, with a last revised date of March 2018, and a last reviewed date of May 21, 2025, revealed, The staff and physician will identify pertinent interventions to try to prevent subsequent falls and to address the risks of clinically significant consequences of falling. The staff and physician will monitor and document the individual ' s response to interventions intended to reduce falling or the consequences of falling. […]

• No harm, potential for more than minimal, patternF692Nov 26, 2025

  Based on facility policy review, clinical record review, and resident and staff interviews, it was determined that the facility failed to ensure proper monitoring to maintain acceptable parameters of nutritional status for two of 19 residents reviewed (Residents 4 and 85). Findings include: Review of facility policy, titled Weighing and Measuring a Resident last reviewed May 21, 2025, read, in part, The purposes of this procedure are to determine the resident's weight and height, to provide a baseline and an ongoing record of the resident's body weight as an indicator of the nutritional status and medical condition of the resident. Review the resident's care plan to assess for any special needs of the resident. […]