F0609

D

Failure to Report Resident’s Verbal Abuse Allegation to State Agency

Chrisman, Illinois Survey Completed on 03-19-2026

Penalty

No penalty information released

Summary

The deficiency involves the facility’s failure to report an allegation of verbal abuse to the state survey agency as required by its Abuse Prevention Program. The written policy dated October 2022 states that visitors are encouraged to report suspected abuse to the administrator or an immediate supervisor, who must then report to the administrator, and that the facility will report allegations of abuse to the Illinois Department of Public Health (IDPH). A cognitively intact resident (R6), per a recent Minimum Data Set, reported that about a week prior, a CNA (V41) assisted with a bedpan during the night. During this interaction, when the resident stated they could not decide if they were too hot or too cold, the CNA responded that the resident had better make up their mind because the CNA was not going to keep coming into the room every five minutes and was only required to come in every two hours. The resident perceived this as scolding, belittling, and a violation of dignity, and characterized it as abuse.

R6 stated they believed they had reported this concern to a corporate marketer (V42) the previous Thursday. When surveyors reviewed the facility’s abuse log on 3/17/26, there were no documented allegations involving this resident. The allegation was reported to the DON (V2) on 3/17/26 at 12:10 PM. Upon interview, the DON stated that V42 had spoken with the resident the day before and the resident reportedly did not recall the incident, and therefore the DON did not report the allegation to IDPH because abuse was not suspected. The DON stated the allegation was reported to the corporate administrator (V9), but no report was made to the state survey agency, resulting in a failure to follow the facility’s policy and regulatory requirements for reporting allegations of abuse.