Below average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Arc At Dwight during CMS and state inspections, most recent first.
The facility failed to prevent resident-to-resident verbal abuse among multiple residents with known behavioral and mood issues, including depression, anxiety, dementia, and documented histories of verbal and aggressive behaviors. In one incident, a resident with poor impulse control repeatedly shouted profane, derogatory language at another resident over a dining seat and shoved a chair that struck the other resident’s wheelchair. In a separate incident, two residents with care plans noting aggressive or verbal behaviors exchanged rude remarks during a dining interaction, with one resident reporting being kicked and responding by calling the other a profane name, which the administrator acknowledged as verbal abuse.
The facility failed to protect several residents from sexual, verbal, and physical abuse by other residents. A cognitively impaired female resident with no capacity for sexual consent was found in a male resident’s room with her gown lifted while the male, who had a history of sexually inappropriate behavior, was touching her bare breast. Two roommates, one with moderate and one with severe cognitive impairment, engaged in repeated episodes of yelling and profanity, with the more intact resident calling the other demeaning names over several weeks despite staff awareness. Additional altercations occurred when one resident grabbed another’s nose after an unwanted wheelchair push, and in a separate lobby incident where two residents bumped into each other, yelled, and grabbed each other’s wrists or arms, reflecting ongoing resident-to-resident physical contact and conflict that was not effectively prevented.
Staff failed to follow the facility’s abuse reporting policy by not reporting multiple instances of resident-to-resident verbal abuse to the administrator. Housekeeping staff and a CNA observed two roommates with cognitive impairment repeatedly yelling and cursing at each other, including using explicit insults, over an extended period but did not escalate these concerns beyond nursing staff. In a separate incident, a housekeeper witnessed a cognitively impaired resident yelling at a roommate and making an obscene hand gesture, yet did not report this as possible abuse, assuming the presence of a CNA was sufficient. None of these events were entered into the abuse log, and the administrator later confirmed that these behaviors should have been reported as potential abuse.
The facility failed to follow its abuse prevention policy by not implementing enhanced monitoring during two separate resident altercations under investigation. In one incident near the nurse’s station, two residents argued after one pushed the other’s wheelchair, leading to a nose grab and physical contact that was later reenacted on a CNA in the presence of an RN. In another incident in the lobby, an anxious resident yelling about harm to a family member bumped a resident in a wheelchair and then grabbed that resident’s wrist. For both events, records and interviews showed that 15-minute checks or 1:1 supervision were not initiated or documented; instead, staff only checked on the involved residents about every two hours while monitoring behaviors.
A resident with severe cognitive impairment had repeated episodes of disrobing, including removing clothing in hallways and entering another resident’s room while holding up her gown, during which the other resident touched her breast. Behavior tracking and nursing notes documented multiple disrobing incidents and increased confusion with hallucinations. However, the care plan only addressed wandering and a single incident of pulling her top up in another resident’s room and did not include a defined problem, goals, or interventions for ongoing public disrobing behaviors. The DON acknowledged that these behaviors were not new and confirmed that the care plan lacked specific measures to address them, despite a facility abuse prevention policy requiring identification and care planning of behaviors that might lead to conflict or abuse.
Two residents with severe cognitive impairment experienced falls when staff did not follow the facility’s fall-prevention policies and did not complete thorough fall investigations. For one resident requiring one-person assist for transfers, a CNA transferred the resident from wheelchair to bed without a gait belt, contrary to policy, and the resident was lowered to the floor and hit her head on a trash can; the fall investigation lacked any CNA statement or documentation of gait belt use. For another resident needing partial/moderate assist and incontinent of urine and bowel, two unwitnessed falls occurred, including one with a large skin tear, and the investigations did not document when the resident was last checked or toileted. The resident’s care plan called for a low bed with a fall mat and scheduled toileting, but surveyors observed no fall mat in place when the resident was in bed, and staff confirmed that the investigations did not include staff interviews or timing of toileting or checks.
A resident with severe cognitive impairment and bilateral upper and lower extremity impairments, fully dependent on staff for transfers, was transferred using a full-body mechanical lift that had a broken plastic component on the spreader bar where sling straps attach. Facility policy and the manufacturer’s manual required daily safety checks and removal from service of equipment in questionable condition, but staff used the lift despite the broken circular piece that normally prevents sling straps from coming out. A CNA and the Maintenance Director both confirmed the damage to the lift, and the Administrator acknowledged that the lift should have been taken out of service and reported, resulting in an unsafe mechanical lift transfer for the dependent resident.
The facility did not employ a clinically qualified director of food and nutrition services, instead assigning a dietary manager who lacked the required clinical nutrition training and credentials. All residents, including a resident receiving gastrostomy tube feedings, were affected as the facility did not meet state requirements for oversight of nutritional services.
Three Dietary Aides without Food Handler's certification were found to be working in food preparation and meal service, including serving food and operating the dishwasher. This was confirmed by the Dietary Manager and facility records, affecting all residents who consumed food from the facility kitchen.
Several residents who received meal trays in their rooms consistently experienced delayed meal service, with meals arriving significantly later than the posted times. Staff interviews indicated that insufficient kitchen staffing and the practice of serving dining room residents first contributed to the delays, resulting in residents routinely waiting for their meals beyond the scheduled service times.
A resident was administered Levothyroxine, Omeprazole, and Acetaminophen together during the same early morning medication pass, contrary to pharmacy guidance requiring Levothyroxine to be given on an empty stomach and separated from other medications. This resulted in three medication errors and a 10% medication error rate, as confirmed by the DON and facility records.
A cognitively intact resident was observed inappropriately touching a severely cognitively impaired resident in a LTC facility. The incident was witnessed by a CNA, who reported it to the facility administrator. Despite the facility's policy on abuse prevention, the event occurred, indicating a failure in protective measures.
The facility failed to report an allegation of sexual abuse involving two residents to the state survey agency. A CNA witnessed inappropriate touching and reported it to an RN, who informed the administrator. The administrator conducted an internal investigation but did not report the incident, believing it was not abuse. The facility's policy requires immediate reporting of such allegations to the Department of Public Health.
Failure to Prevent Resident-to-Resident Verbal Abuse Among Residents With Known Behavioral Issues
Penalty
Summary
The facility failed to protect residents from resident-to-resident verbal abuse, despite a policy stating that each resident has the right to be free from abuse, including verbal abuse defined as disparaging or derogatory language within a resident’s hearing. One incident involved a resident (R3) with major depressive disorder, a history of behavior problems, poor impulse control, and a care plan noting that the resident is easily angered and will threaten others verbally and physically. During a conflict over a preferred dining spot, R3 yelled repeated expletives at another resident (R1), calling her a “f****** b****,” and shoved a nearby chair toward R1’s wheelchair, with the chair striking the wheelchair. The administrator acknowledged that R3 has a problem with becoming verbally aggressive with other residents and confirmed that R3 was verbally abusive toward R1. Another incident involved two cognitively intact or moderately impaired residents (R1 and R2), both with documented histories or care plans indicating verbal or aggressive behaviors. R1 has major depressive disorder, anxiety, dementia, and a care plan noting issues with verbal/aggressive behaviors, difficulty getting along with others, and a tendency to be mean to others and rush into the dining room. R2 has a care plan for potential aggressive verbal behavior and a tendency to lash out at others when bothered or annoyed. During a dining room interaction, an activity aide heard R2 yell “ouch, that hurts” and was told by R2 that R1 had kicked her; R2 then called R1 a “b***.” The aide confirmed hearing the verbal insult, and the administrator later stated that R2 calling R1 a “b***” was a form of verbal abuse and should be reported. Incident notes for both R1 and R2 documented that they exchanged rude remarks and came into contact with each other, demonstrating that resident-to-resident verbal abuse occurred among multiple residents with known behavioral issues.
Failure to Protect Residents From Sexual, Verbal, and Physical Abuse by Other Residents
Penalty
Summary
The deficiency involves the facility’s failure to protect multiple residents from abuse by other residents, including sexual, verbal/mental, and physical abuse, as defined in the facility’s Abuse Prevention and Reporting policy. In one incident, a CNA observed a cognitively impaired female resident with severe impairment, hallucinations, wandering behavior, and no capacity for sexual consent standing in a male resident’s room with her feet on his bed, holding up her nightgown without a bra, while the male resident, who has moderate cognitive impairment and a documented history of sexually inappropriate behaviors and poor self-regulation, had his hand on her bare breast. The CNA questioned both residents, but neither responded. Subsequent interviews showed that both residents did not recall the incident, and the social services director confirmed that the female resident lacked capacity to consent to sexual relationships, while the male resident was assessed as having capacity but also did not recall the event. The deficiency also includes the facility’s failure to protect a severely cognitively impaired resident from ongoing verbal/mental abuse by a moderately cognitively impaired roommate. Housekeeping and CNA staff reported witnessing repeated episodes over a period of weeks in which the more cognitively intact roommate yelled at and cursed the other, including calling the roommate a “f****** dummy” and using other profanities when the severely impaired resident was confused or forgetful. Staff reported these interactions to nursing and suggested a room change, but the verbal exchanges continued, with staff again observing the more intact resident yelling profanities at the roommate. At the time of survey, the two residents were still sharing a room, and the severely impaired resident either minimized the interactions or did not recall them. Additional incidents involved physical contact between residents that met the facility’s definition of physical abuse. In one case, a cognitively intact resident reported that another resident with moderate cognitive impairment pushed the wheelchair despite being told not to, leading the intact resident to grab the other resident’s nose; the cognitively impaired resident then grabbed or pushed the other resident’s hand or arm away. A CNA later had the cognitively impaired resident demonstrate what occurred, and the resident reenacted the nose grab. In another incident, a cognitively intact resident witness and interviews indicated that an anxious resident in the lobby bumped another resident’s wheelchair, leading to mutual yelling and each resident grabbing the other’s wrist or arm. These events, involving residents with varying levels of cognitive function and documented behavioral issues, show repeated resident-to-resident physical contact and altercations without effective prevention or protection by the facility.
Failure to Report Resident-to-Resident Verbal Abuse Allegations to Administration
Penalty
Summary
The deficiency involves the facility’s failure to report allegations and observations of resident-to-resident verbal abuse to the administrator as required by its Abuse Prevention and Reporting policy. The policy defines verbal abuse as oral or gestured communication such as yelling, mocking, insulting, and ridiculing, and directs staff to consider resident-to-resident altercations as potential abuse that must be investigated and immediately reported to the administrator. Housekeeping and CNA staff reported that two cognitively impaired roommates frequently yelled and cursed at each other, including statements such as “f*** you,” “f****** dummy,” and “you just asked that God d*** it,” over a period of weeks. These staff members acknowledged they would consider this behavior verbal abuse but did not report it to the administrator, instead assuming that because nursing staff or CNAs were aware, no further reporting was needed. The abuse log contained no entry for these incidents, and the administrator confirmed that this situation had not been reported. The deficiency also includes a separate incident involving another pair of roommates, one of whom had moderate cognitive impairment. A housekeeper reported hearing yelling between these two residents and witnessing one resident give the other the middle finger. The housekeeper did not report this as possible abuse, believing that the presence of a CNA in the room was sufficient and expressing uncertainty about whether this behavior constituted abuse due to the residents’ illnesses. The abuse log contained no allegation involving this resident, and the administrator later confirmed that staff should have reported the allegation of one resident giving the other the middle finger. In both situations, staff failed to follow the facility’s policy requiring immediate reporting of suspected abuse to the administrator, resulting in unreported allegations of resident-to-resident verbal abuse for four residents.
Failure to Implement Enhanced Monitoring During Abuse Investigations
Penalty
Summary
The deficiency involves the facility’s failure to implement required protective measures during abuse investigations involving three residents. Facility policy dated December 2025 states that during an abuse investigation, the facility will take steps to prevent potential abuse, including assessing residents who allegedly abuse others to determine appropriate care approaches and placement, and taking all necessary steps to ensure safety, such as separating involved residents. On one occasion, an altercation occurred near the nurse’s station when one resident pushed another resident’s wheelchair, leading the second resident, who was alert and oriented, to grab the first resident’s nose, after which the first resident pushed the other’s hand/arm away. A CNA later asked the first resident to demonstrate what happened, and the resident grabbed and twisted the CNA’s nose, with an RN present. Interviews and record review showed no documentation that 15-minute checks or one-to-one supervision were implemented for either resident during the investigation of this allegation, despite staff acknowledging that such checks are sometimes used and are documented on paper forms uploaded into the EMR. In a separate incident, another resident was observed in the front lobby yelling that someone was trying to kill the resident’s son and made contact with a second resident in a wheelchair. Witness and resident interviews documented that the first resident bumped the second resident’s wheelchair, the second resident bumped back, and then the first resident grabbed the second resident’s wrist, though no injury was reported. Review of both residents’ medical records showed no documentation that 15-minute checks or one-to-one supervision were implemented during the investigation of this second abuse allegation. The administrator confirmed that for both incidents, 15-minute checks or one-to-one monitoring were not used and that staff instead checked on the residents every two hours and monitored their behaviors, contrary to the facility’s abuse prevention and reporting policy requirements for ensuring resident safety during abuse investigations.
Failure to Care Plan for Resident’s Recurrent Public Disrobing Behaviors
Penalty
Summary
The deficiency involves the facility’s failure to develop a complete care plan with problem, goals, and measurable interventions to address a resident’s ongoing behaviors of public disrobing. The resident had a Minimum Data Set documenting severe cognitive impairment and behavior tracking that showed repeated disrobing episodes over a one‑month period, including multiple dates where the resident removed clothing or partially disrobed. Nursing documentation noted increased confusion with hallucinations and an incident where the resident removed her gown and had her incontinence brief halfway off while sitting in the hallway, requiring staff assistance with dressing. Despite these documented behaviors, the resident’s care plan, revised on a specified date, only addressed wandering into other residents’ rooms and an incident of pulling her top up in a male resident’s room, and did not include a specific problem, goals, and interventions for public disrobing. An abuse investigation report and CNA interview documented an event where the resident was in another resident’s room holding up her gown while the other resident touched her breast. The DON stated that the resident was not aware of her surroundings and would change her gown in the hallway or come out of her room while putting her top on, and confirmed that this was not a new behavior and that the care plan did not include a problem, goal, and interventions to address the resident’s public disrobing behaviors. The facility’s Abuse Prevention and Reporting policy required staff to identify residents with needs, triggers, and behaviors that might lead to conflict and to care plan problems, goals, and interventions to reduce chances of abuse, which was not done in this case.
Failure to Implement Fall-Prevention Interventions and Conduct Thorough Fall Investigations
Penalty
Summary
The deficiency involves the facility’s failure to implement required fall-prevention interventions and to conduct thorough fall investigations for two cognitively impaired residents. Facility policies required use of gait belts for all non-mechanical lift transfers and mandated that fall interventions be implemented and documented in the care plan, with residents observed every two hours and provided care as care planned. One resident with severe cognitive impairment and substantial/maximal assistance needs for bed mobility and transfers was care planned as a one-assist transfer. A fall report documented that this resident was lowered to the floor by a CNA and bumped her head on a trash can, but the facility’s fall investigation did not include an interview or statement from the CNA and did not document whether a gait belt was used. The documented root cause was weakness due to recent COVID-19 illness, and the only post-fall interventions noted were encouraging fluids and physical therapy. In a later interview, the CNA stated that the resident became weak during a wheelchair-to-bed transfer, that the CNA grabbed the waistband of the resident’s pants to lower her to the floor, and that a gait belt was not used even though it should have been for a one-person transfer. The DON stated that a gait belt should be used for all non-mechanical lift transfers and was unaware that one had not been used, and confirmed that the investigation documentation did not address gait belt use. The second resident also had severe cognitive impairment, required partial/moderate assistance for transfers, and was always incontinent of urine and frequently incontinent of bowel. The care plan included interventions such as keeping the bed in a low position with a landing strip (fall mat) and a toileting plan that was later revised to include toileting every two hours and as needed. An unwitnessed fall report documented that this resident was found on the floor at the foot of the bed with a large skin tear and that the resident reported seeing a dog, going to look for it, and tripping over the floor mat; however, the fall investigation did not document when the resident was last checked or provided toileting/incontinence care. A subsequent unwitnessed fall documented the resident sitting on the floor between the foot pedals of the wheelchair, stating they were trying to put pants on, with the investigation again lacking documentation of when the resident was last checked or toileted. The root cause was listed as an attempt to self-toilet while on COVID-19 isolation, and the intervention was a revised toileting plan. During observations, no fall mat was present beside the resident’s bed despite the care plan calling for a landing strip when the resident was in bed. Staff interviews confirmed recent falls, incontinence at the time of one fall, reliance on the care plan for interventions, and that the fall investigations did not include staff statements or documentation of the timing of toileting or checks prior to the falls.
Unsafe Use of Damaged Mechanical Lift During Dependent Resident Transfer
Penalty
Summary
The deficiency involves the facility’s failure to ensure safe use and maintenance of a mechanical lift during transfers for a resident who was severely cognitively impaired and dependent on staff for all transfers. The resident’s MDS/Quarterly assessment documented severe cognitive impairment, bilateral upper and lower extremity impairments, and total dependence on staff for transfers, with the care plan specifying use of a full-body mechanical lift with two-person assistance. The facility’s written policy on Transfers–Manual Gait Belt and Mechanical Lifts required routine maintenance checks by nursing and maintenance staff to ensure equipment remained in good working order, and the manufacturer’s user manual required completion of a daily checklist before use, including examination of sling hooks and related components for excessive wear and non-use if there was any doubt about safety. Despite these requirements, staff used a mechanical lift with a known broken component on the spreader bar where the sling straps attach. A CNA reported that the full circular plastic piece at one end of the spreader bar, which kept the sling straps from coming out, was broken in half, and confirmed that the side of the sling that came off during the incident was the side with the broken plastic circle piece. The Maintenance Director also confirmed that the lift used on the resident had a broken round plastic piece on the spreader bar, with half of it missing. The Administrator stated that staff should have removed the lift from service and reported the broken piece immediately, indicating that the lift was used for the resident’s transfer while in a damaged and unsafe condition, contrary to facility policy and manufacturer instructions.
Lack of Qualified Director for Food and Nutrition Services
Penalty
Summary
The facility failed to employ a clinically qualified director of food and nutrition services, as required. The individual serving as the dietary manager was certified only as a Food Service Manager, a credential obtained through an eight-hour course focused on cooking sanitation, without clinical nutrition content. The dietary manager confirmed that she had not completed the Certified Dietary Manager (CDM) course, was not a Registered Dietician, had not graduated from an authorized dietetic and nutrition program, had no qualifying food service experience prior to 1990, and had not served in the military in a relevant capacity. She also stated that the facility's Registered Dietician only worked on a consultant basis and was not present in a full-time or supervisory role. All 87 residents in the facility, including at least one resident who receives nutrition solely through gastrostomy tube feedings, were affected by this deficiency, as they all rely on the facility's nutritional services. The lack of a clinically qualified director meant that the facility did not meet state requirements for oversight of its food and nutrition services, particularly in areas involving clinical nutrition needs.
Uncertified Food Handlers Involved in Meal Service
Penalty
Summary
The facility failed to ensure that all food service personnel held the required Food Handler's certificates as mandated by Illinois law. Specifically, three Dietary Aides were identified as not having obtained their Food Handler's certification, yet they were actively involved in meal service and food preparation activities, including serving food trays and plates to residents, preparing utensils for meals, and operating the dishwasher. This deficiency was confirmed through interviews with the Dietary Manager and review of facility records, which documented that these staff members had been working in the kitchen and dining room without the necessary certification. At the time of the survey, 87 residents were residing in the facility, with all but one consuming food prepared and served by the facility's kitchen staff.
Delayed Meal Service for Residents Receiving Room Trays
Penalty
Summary
The facility failed to provide meal service to residents in accordance with the posted meal times, affecting six residents who received meal trays in their rooms. Observations and interviews revealed that these residents consistently received their meals significantly later than the scheduled times, with breakfast trays arriving around 9:00 AM instead of 7:30 AM, lunch around 1:00 PM instead of 11:30 AM, and supper around 6:00 PM instead of 4:30 PM. Residents reported that this delay was a routine occurrence, and staff confirmed that meal trays for residents eating in their rooms were often served late due to insufficient kitchen staffing. The Dietary Manager explained that the kitchen prioritized serving residents in the dining room before preparing and delivering trays to those eating in their rooms, resulting in further delays. The posted meal service times were clearly displayed throughout the facility, but the actual delivery of meals to residents in their rooms did not align with these times. Staff interviews confirmed that the process for identifying and serving residents who required room trays contributed to the late meal service.
Improper Medication Administration Timing Results in Elevated Error Rate
Penalty
Summary
The facility failed to follow proper medication administration protocols for a resident prescribed Levothyroxine, Omeprazole, and Acetaminophen. According to the Medication Administration Record (MAR), these medications were scheduled and administered together during the early morning medication pass. The MAR and electronic medical record indicated that Levothyroxine and Omeprazole were both given at 5:02 am, and Acetaminophen was given at 5:06 am, all within the same medication pass window. The Director of Nursing confirmed that Levothyroxine should not be administered with other medications, as it is required to be given on an empty stomach and separated from other medications to ensure proper absorption. The facility's own pharmacy guidance and medication pamphlet for Levothyroxine specified that it should be administered once daily on an empty stomach, at least half an hour before breakfast and at least four hours apart from other medications that could interfere with its absorption. Despite this, the medications were administered together, resulting in three medication errors out of 30 opportunities, which led to a medication error rate of 10 percent. The error was attributed to a transcription issue that scheduled the medications at the same time.
Failure to Protect Resident from Inappropriate Touching
Penalty
Summary
The facility failed to protect a resident's right to be free from inappropriate touching by another resident. The incident involved two residents, one of whom was cognitively intact with a BIMS score of 13, while the other had severe cognitive impairment with a BIMS score of 4. The incident was observed by a CNA who saw the cognitively intact resident with their hand inside the brief of the cognitively impaired resident, whose shirt was pulled up to their belly button. This inappropriate touching was reported to the facility administrator by the CNA. The facility's policy on 'Abuse Prevention and Reporting' emphasizes the residents' right to be free from abuse and the facility's commitment to preventing such occurrences. Despite this policy, the incident occurred, indicating a failure in the facility's protective measures. The incident was documented in the residents' records, and the facility administrator was informed by the CNA who witnessed the event. The report highlights the facility's inability to prevent the inappropriate interaction between the two residents, which constitutes a deficiency in ensuring resident safety and protection from abuse.
Failure to Report Alleged Sexual Abuse
Penalty
Summary
The facility failed to report an allegation of sexual abuse involving two residents to the state survey agency, as required by their policy. The incident involved a resident with severe cognitive impairment and another resident with moderately impaired cognition. The facility's policy mandates that any suspicion or allegation of abuse must be reported immediately to the administrator and then to the Department of Public Health's regional office. However, the administrator conducted an internal investigation and decided not to report the incident, believing it was not abuse. The incident was initially reported by a Certified Nursing Assistant (CNA) who witnessed one resident appearing to touch another resident inappropriately. The CNA reported this to a Registered Nurse (RN), who then informed the administrator. Despite this, the administrator instructed the RN not to document the incident and did not report it to the state agency. Additionally, a hospice social worker was informed of the incident by a hospice CNA and was told by the facility's administrator and Director of Nursing that they were handling the investigation internally and had moved the resident to a different room.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Dwight
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Evenglow Lodge | 18.2 mi | ★★★★★ | 0 | 0 |
| Accolade Healthcare Of Pontiac | 18.9 mi | ★★★★★ | 4 | 0 |
| Serenity Estates At Morris | 18.9 mi | ★★★★★ | 22 | 0 |
| Arcadia Care Morris | 19.7 mi | ★★★★★ | 5 | 0 |
| Arc At Streator | 20.3 mi | ★★★★★ | 6 | 0 |
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