Elevate Care Country Club Hill

In the surveyor’s words

From the most serious findings on record at Elevate Care Country Club Hill, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Aug 26, 2022

  Based on observations, interviews, and records reviewed the facility failed to ensure staff used a full body mechanical lift per the manufacturers recommendations to ensure the machine is balanced during 3 resident (R3, R4, R12) transfers. In addition, the facility failed to identify 2 residents (R3, R4) of 3 residents requiring the use of a mechanical lift for transfers. This failure has the potential to affect 58 residents transferred with the full body mechanical lift. This failure resulted in R4 suffering a closed head injury. The facility also failed to develop a plan to prevent or reduce the risk of an avoidable accident of dislodging a temporary [CONDITION(S)] catheter for a resident with involuntary jerking movements. […]

• Actual harm, isolatedF689Jul 15, 2026

  Based on interview and record review, the facility failed to supervise one resident that was identified as a high risk with severe cognitive impairment and a history of falls who required one person assist with transfers. This affected one of three residents (R1) reviewed for falls and supervision. This failure resulted in R1 having an unwitnessed fall while self-transferring sustaining left cervical spine (C1) and (C5) fracture.Findings Includes: R1 current diagnoses include but not limited to Alzheimer Disease, Parkinson's Disease, Dementia and a history of falling. R1Minimal data set section C (cognitive patterns) dated 4/22/26 documents a score of three which indicates severe cognitive impairment. […]

• Actual harm, isolatedF689Feb 7, 2026

  Based on interview and record review, the facility failed to implement fall preventive measures for a resident who is a 2 person transfer assist due to increased weakness and behaviors. This deficiency affects one (R1) of three residents reviewed for Falls prevention program. This failure resulted in R1 being hospitalized and treated for a Closed Fracture of Left ankle. Findings include:R1 is a [AGE] year-old admitted to the facility on [DATE] with the following diagnoses in part but not limited to: cerebral palsy, unspecified convulsions, spastic hemiplegic cerebral palsy, other disorders of muscle, reduced mobility, vascular dementia, essential hypertension, Paroxysmal atrial fibrillation, gastro-esophageal reflux disease, cardiomyopathy, hypothyroidism, autistic disorder, schizophrenia,… […]

• Actual harm, isolatedF684Nov 20, 2025

  Based on observation, interview and record review, the facility failed to provide necessary assistance for one dependent resident (R149) in accordance with care plan by failing to complete weekly shower/skin assessment as ordered. This failure affected one (R149) of six residents reviewed for Activities of Daily Living (ADL) care. R149 developed a hematoma to her right great toe at the facility, complaint of pain where it was noted R149's wound was infected, and an x-ray revealed a fracture to the right great toe. […]

• Actual harm, isolatedF684Dec 12, 2024

  Based on interview and record review, the facility failed to transcribe physician orders for comfort care medications for a resident admitted to hospice care services. This failure affected one (R1) of five residents reviewed for physician orders and resulted in R1 having untreated pain for several days before expiring in the facility. Findings include: R1 was originally admitted to the facility [DATE] with diagnoses that included but are not limited to malignant colon cancer. According to R1's electronic health record, progress notes of [DATE] indicate R1 went to an outpatient oncology appointment and was hospitalized with a diagnosis of adult failure to thrive. […]