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 Westwood Vlge Nrsg And Rhb Ctr during CMS and state inspections, most recent first.
The facility failed to provide accurate quarterly statements for resident trust fund accounts and did not issue any quarterly statements to multiple residents with Individual Resident Fund accounts. A cognitively intact resident with multiple chronic conditions reported not receiving expected trust fund money and being limited to smaller withdrawals than the balance shown on the Resident Trust Sheet, and stated he had never received a quarterly statement. Other cognitively intact residents reported receiving regular $30 disbursements but never receiving quarterly statements, and one resident stated he requested an audit but was not given an account statement. Another resident with moderately impaired cognition also reported never receiving a quarterly statement. The Business Office Manager confirmed that quarterly statements had not been provided for an extended period, that residents only saw balances at the time of weekly withdrawals, and that the balances on the trust fund sheets were inaccurate because deposits and credits were not included and did not match RFMS records, contrary to facility policy requiring quarterly transaction statements.
A resident with a history of schizoaffective disorder and other medical conditions was physically abused by another resident during an altercation over a cigarette on the patio. Witnesses, including another resident and an LPN, confirmed that the aggressor slapped the resident in the face and took her cigarette, despite the facility's abuse prevention policy prohibiting such actions.
A deficiency was cited when a resident was not protected from various forms of abuse and neglect, including physical, mental, and sexual abuse, as well as physical punishment, due to insufficient safeguards and oversight by the facility.
Multiple residents were exposed to room temperatures above the required range due to malfunctioning AC units and inadequate staff response. Several staff members, including LPNs and CNAs, were aware of the excessive heat and leaking AC units but did not consistently report or escalate the issue. Residents with complex medical conditions experienced discomfort and some were only relocated after the fire department intervened, as facility policies for monitoring and reporting high temperatures were not consistently followed.
A resident reported verbal abuse by a nurse, but the facility failed to follow its abuse prevention policy. The Director of Nursing counseled the nurse and reassigned the resident but did not document an incident report or conduct a thorough investigation as required.
A resident reported unauthorized use of their cash app and verbal abuse by a nurse. The facility failed to report these allegations to the state agency within the required timeframe, violating regulatory requirements for timely reporting of abuse and misappropriation.
A resident reported verbal abuse by a nurse and a separate theft incident involving her cash app. The facility failed to conduct thorough investigations, as required by its abuse prevention program, by not interviewing other potential witnesses and lacking detailed documentation. The Administrator was not informed of the theft allegation, and witness statements were incomplete.
Two residents in an LTC facility experienced significant medication administration errors, with medications being administered late on multiple occasions. One resident with seizures did not receive their Advair inhaler and Divalproex on time, while another resident with Parkinson's and schizophrenia had delays in receiving Carbidopa-Levodopa and Quetiapine. The facility's policy requires medications to be administered within one hour of the scheduled time, which was not followed.
The facility did not follow its policy to label and date food items in the dry storage area, risking the use of expired food. Observations revealed unlabeled bread, bananas, potatoes, and frozen squash. The cook, Food Services Director, and Dietician confirmed the importance of labeling to prevent foodborne illness and ensure quality.
A facility failed to administer medications timely for seven residents, as observed during a medication pass by an LPN. The LPN cited accommodating resident requests and conversations as reasons for the delay. The facility's policy allows a one-hour window before and after the scheduled time for medication administration, but the LPN did not complete the task within this timeframe, and there was no indication of physician notification for the late administration.
The facility failed to assess two residents with COPD for self-administration of albuterol inhalers, despite their requests to keep the inhalers at bedside for immediate use. Both residents, with intact cognition, were denied the ability to self-administer without evaluation, contrary to facility policy. The DON acknowledged the oversight and noted no apparent reason preventing safe self-administration.
A resident's call light was not within reach, as observed during a survey. The resident confirmed they had to get up to access it, and the DON acknowledged the issue. The facility's policy requires call lights to be within easy reach, and the Administrator expects staff to ensure this during room checks.
The facility failed to properly store insulin and remove expired supplies, affecting two residents. Expired insulin was found in medication carts, and expired g-tube supplies were found in the storage room. The DON stated that insulin should be labeled with open and expiration dates, and expired supplies should be removed, but these procedures were not followed.
An LPN failed to clean and disinfect a reusable blood pressure cuff between uses on three residents, as observed by surveyors. The facility's policy requires disinfection of non-critical items like blood pressure cuffs between residents to prevent infection spread, a protocol confirmed by the DON and Infection Control Preventionist.
A resident with multiple diagnoses and high fall risk was found alone in her room attempting to transfer to her wheelchair, which was out of reach. The call light was missing its cord, and no 1:1 supervision was present. The resident had a history of significant falls, and the facility failed to follow the care plan interventions and provide adequate supervision.
Failure to Provide Accurate Quarterly Resident Trust Fund Statements
Penalty
Summary
The facility failed to provide accurate quarterly statements for residents’ personal trust fund accounts and did not issue any quarterly statements at all to several residents with Individual Resident Fund accounts. One resident with intact cognition, diagnosed with Parkinson’s disease, dementia, hypertensive heart disease, anemia, dysphagia, cognitive communication deficit, osteoarthritis of the hip, scoliosis, insomnia, benign prostatic hyperplasia, major depressive disorder, and blepharospasm, reported not receiving trust fund money for the last two weeks and stated he was denied access to the full $200 reflected on his Resident Trust Sheet, being told he could only receive $30. He also reported never receiving a quarterly statement during his stay. Other cognitively intact residents reported that they regularly received $30 from their trust fund but had never received quarterly statements, and one resident stated he had requested an audit of his account but was not provided with a statement and wanted to receive it regularly. Another resident with moderately impaired cognition similarly reported never receiving a quarterly statement of the trust fund account. The Business Office Manager confirmed that quarterly statements were not being provided to residents and explained that residents only saw their balance when they received weekly trust fund money. The Business Office Manager further acknowledged that the balances on the Resident Trust Fund Sheets were inaccurate because they did not include deposits or credits and did not match the balances reflected on the RFMS statements. The Business Office Manager stated that quarterly statements had not been provided since 2023. Facility policy on Resident Personal Trust Fund, dated 4/15/2024, requires that a quarterly statement of all transactions, including withdrawals, direct charges, deposits, and interest, be prepared and provided to the resident or legal representative. A CMS Form 671 documented that 111 residents resided in the facility at the time of the survey, indicating the potential for this deficiency to affect all residents with trust fund accounts.
Failure to Protect Resident from Physical Abuse by Another Resident
Penalty
Summary
A deficiency occurred when the facility failed to protect a resident from abuse by another resident. The incident involved a cognitively intact resident with multiple diagnoses, including schizoaffective disorder and chronic obstructive pulmonary disease, who was slapped in the face by another resident during an altercation on the patio over a cigarette. Multiple witness statements, including those from another resident and an LPN, confirmed that the altercation took place, with the aggressor asking for a light, being refused, and then slapping the other resident and taking her cigarette. The resident who was struck became agitated when questioned and refused to provide a statement to police or press charges, but documentation and witness accounts consistently described the physical abuse. The facility's records, including progress notes and incident reports, documented the altercation and the subsequent investigation. The abuse prevention policy in place affirms residents' rights to be free from abuse, including physical abuse such as hitting or slapping. Despite this policy, the facility did not prevent the incident, and the resident was subjected to physical abuse by another resident. The incident was reported, and the aggressor was removed from the area and placed on 1:1 monitoring, but the deficiency centers on the failure to ensure the resident's right to be free from abuse.
Failure to Protect Residents from Abuse and Neglect
Penalty
Summary
A deficiency was identified regarding the facility's failure to protect residents from all forms of abuse, including physical, mental, and sexual abuse, physical punishment, and neglect by any individual. The report notes that residents were not adequately safeguarded against these types of mistreatment, indicating lapses in the facility's protective measures and oversight.
Failure to Maintain Safe Resident Room Temperatures
Penalty
Summary
The facility failed to maintain resident room air temperatures within the required range of 71 to 81 degrees Fahrenheit for at least 23 residents, resulting in multiple rooms reaching temperatures as high as 88 degrees Fahrenheit. Several residents reported that their rooms were uncomfortably hot for multiple days, with some air conditioning (AC) units leaking water and failing to provide adequate cooling. Residents with significant medical histories, including diabetes, chronic obstructive pulmonary disease (COPD), heart disease, and other chronic conditions, were affected. Some residents requested to be moved to cooler rooms, while others endured the heat until the fire department intervened. Staff interviews revealed that multiple staff members, including LPNs, CNAs, and housekeeping, were aware of the elevated temperatures and malfunctioning AC units but did not consistently report these issues to supervisors or take further action. Some staff believed there was nothing they could do about the AC problems, especially on weekends, and did not escalate the concerns to the Administrator or Director of Nursing (DON). The facility's maintenance director was on vacation during the incident, and housekeeping staff, who were responsible for monitoring room temperatures, did not always communicate elevated readings or resident complaints to the appropriate personnel. Facility policies required staff to monitor and report high temperatures and to relocate residents if necessary, but these procedures were not consistently followed. Documentation showed that several rooms exceeded the 81-degree threshold, and the facility's own logs confirmed elevated temperatures during the period in question. The deficiency was only addressed after a resident called 911, prompting the fire department to intervene and direct the relocation of residents from overheated rooms.
Failure to Implement Abuse Prevention Program
Penalty
Summary
The facility failed to follow its abuse prevention policy and procedures, resulting in a deficiency related to the handling of a resident's complaint. A resident (R1) reported that a nurse (V5) was yelling at her during medication pass, which was documented on a concern form and given to the Director of Nursing (V2). However, the facility did not document an incident report or conduct a thorough investigation as required by their abuse prevention program. The program mandates a written report within 24 hours, interviews with witnesses, the resident, and staff, and a review of the circumstances surrounding the incident, none of which were completed. The Director of Nursing (V2) only counseled the nurse (V5) about her tone of voice and reassigned the resident to another nurse, without suspending V5 or conducting further investigation. The Administrator/Abuse Coordinator (V1) was on vacation, and the Director of Nursing (V2) did not report the incident to her. The facility's failure to implement the abuse prevention program and document the incident properly led to the deficiency, as the necessary steps to address and investigate the alleged verbal abuse were not taken.
Failure to Timely Report Abuse and Misappropriation Allegations
Penalty
Summary
The facility failed to adhere to its abuse prevention program by not reporting allegations of verbal abuse and misappropriation of funds to the state surveying agency within the required timeframe. A resident, who was cognitively intact with a BIMS score of 15, reported that staff were using their cash app without permission, leading to unauthorized transactions. Despite the resident's concern being documented on a form, the facility did not report the theft allegation to the state agency until 15 days later, which is a violation of the regulatory requirement to report such incidents within 24 hours. Additionally, the same resident reported verbal abuse by a registered nurse during medication administration. Although the concern was documented and the nurse was counseled, the Director of Nursing did not report the verbal abuse allegation to the state surveying agency as required. The facility's abuse prevention program mandates immediate notification to the state agency for any abuse allegations, but the initial incident report was only submitted after the surveyor's inquiry, indicating a failure to comply with the regulatory requirement to report abuse within one hour.
Inadequate Investigation of Abuse and Theft Allegations
Penalty
Summary
The facility failed to adhere to its abuse prevention program and did not conduct a thorough investigation into an alleged incident involving a resident and a nurse. The resident, who had an intact cognition as determined by a BIMS score of 15, reported that a nurse was yelling at her during medication pass. The incident was reported to the Director of Nursing, but the investigation was incomplete as it did not include interviews with other residents who might have witnessed the event. The staff's witness statements lacked specific details such as the date and type of event, and some staff members who provided statements were not present during the alleged incident. Additionally, the facility did not properly investigate a separate allegation of theft reported by the same resident. The resident believed that someone had accessed her phone and used her cash app without permission. The Social Service Director was informed of the incident, but the Administrator was not made aware, and no documentation of an investigation was provided. The facility's abuse prevention program requires that any incident involving abuse, neglect, exploitation, mistreatment, or misappropriation of resident property be thoroughly investigated, including interviews with relevant individuals and review of pertinent documents. The facility's failure to conduct comprehensive investigations into these allegations indicates a lack of adherence to its own policies and procedures. The absence of detailed witness statements and the failure to interview potential witnesses, such as other residents, contributed to the deficiency. Furthermore, the lack of documentation and communication regarding the theft allegation highlights a gap in the facility's response to potential exploitation or misappropriation of resident property.
Medication Administration Errors in LTC Facility
Penalty
Summary
The facility failed to ensure that residents were free from significant medication errors, as evidenced by the late administration of medications for two residents. Resident 1, who has a diagnosis of seizures and a BIMS score indicating intact cognition, reported that their Advair inhaler was not administered at the scheduled time of 6am and 6pm, with documented late administrations on multiple occasions. Additionally, their Divalproex medication was also administered late on two separate days, with delays of up to 6.25 hours past the scheduled time. Resident 3, diagnosed with Parkinson's disease and disorganized schizophrenia, also experienced late medication administration. Their Carbidopa-Levodopa and Quetiapine medications, scheduled for three times daily, were documented as being administered late on two consecutive days. The facility's policy requires medications to be administered within one hour before or after the scheduled time, which was not adhered to in these cases. The Director of Nursing confirmed the regulatory requirement for timely medication administration, highlighting the facility's failure to follow its own policy and procedures.
Failure to Label and Date Food Items in Storage
Penalty
Summary
The facility failed to adhere to its policy regarding the labeling and dating of food items in the dry food storage area, which could potentially affect all residents. During an observation, it was noted that several food items, including bread, bananas, potatoes, and frozen squash, were not labeled with dates. The cook acknowledged that these items should have been dated. The Food Services Director confirmed that all food is supposed to be labeled upon arrival to prevent the use of expired food. The Dietician also emphasized the importance of labeling to track expiration dates and ensure food safety. The facility's policy on labeling and dating foods aims to reduce the risk of foodborne illness and maintain high food quality by requiring that foods be labeled with the date received, the date opened, and the discard date.
Medication Administration Delays in LTC Facility
Penalty
Summary
The facility failed to administer medications timely and did not adhere to its medication administration policy for seven residents. During an observation, a Licensed Practical Nurse (LPN) was seen administering medications past the scheduled time for seven residents. The LPN explained that the delay was due to accommodating specific requests from residents and engaging in conversations with them, which extended the time needed to complete the medication pass. The facility's policy allows medications to be administered one hour before or after the scheduled time, and any administration beyond this window is considered late. The Assistant Director of Nursing confirmed that medications scheduled for 9:00 AM could be administered between 8:00 AM and 10:00 AM. If medications are administered past this window, the nurse must inform the resident of the delay and notify the physician. The LPN did not complete the medication administration by the required time, and there was no indication that the physician was notified of the late administration. The residents involved had various medical conditions, including schizoaffective disorder, hypertension, diabetes, multiple sclerosis, and major depressive disorder. Their care plans documented the need for specific medications to manage these conditions. The failure to administer medications on time could potentially impact the management of their health conditions, although the report does not specify any direct consequences resulting from the delay.
Failure to Assess Residents for Self-Administration of Albuterol Inhalers
Penalty
Summary
The facility failed to adhere to its policy regarding the assessment of residents for self-administration of medications, specifically albuterol inhalers, for two residents with chronic obstructive pulmonary disease (COPD). Both residents, identified as R58 and R79, expressed a desire to have their rescue inhalers at their bedside for immediate use during exacerbations of shortness of breath. However, neither resident was assessed by the nursing staff for their ability to self-administer the medication, as required by the facility's policy. R58, a resident with a BIMS score indicating intact cognition, reported that despite requesting to keep the inhaler at bedside, the nursing staff denied the request without conducting an evaluation. The Director of Nursing (DON) confirmed that R58 had not been assessed for self-administration and acknowledged that there was no apparent reason preventing R58 from safely self-administering the medication. Similarly, R79, also with intact cognition, expressed concerns about the delay in receiving the inhaler during an exacerbation and stated that multiple requests to keep the inhaler at bedside were denied without assessment. The facility's policies require that residents who wish to self-administer medications be assessed by the interdisciplinary care plan team, with results communicated to the attending physician for approval. Despite these policies, the facility did not conduct the necessary assessments for R58 and R79, resulting in a failure to allow these residents to self-administer their albuterol inhalers as clinically appropriate.
Call Light Accessibility Deficiency
Penalty
Summary
The facility failed to ensure that a call light was within reach of a resident, identified as R32, during a survey. On December 9, 2024, at 12:00 PM, it was observed that R32's bed was placed along one wall, while the call light was located on an adjacent wall, beyond the reach of the resident. When asked by the surveyor, R32 confirmed that they had to get up to reach the call light. The Director of Nursing (DON), identified as V2, acknowledged that there was no way for R32 to reach the call light from the bed. Later, at 3:00 PM, V2 reiterated that the purpose of call lights is to alert staff when a resident needs help, and the cord should be within the resident's reach. The facility's policy, dated August 2008, also states that call lights should be within easy reach of residents when they are in bed or confined to a chair. On December 11, 2024, the Administrator, identified as V1, stated that they expect call lights to be within reach and functioning, and staff should check this when entering rooms.
Improper Storage of Insulin and Expired Supplies
Penalty
Summary
The facility failed to properly store insulin medications and gastrostomy tube (g-tube) feeding extension tubing supplies, impacting two residents. During an inspection of the medication carts, expired insulin was found for two residents. One resident's Novolog FlexPen U-100 Insulin was marked with an open date of 07/24/2024 and an expiration date of 08/21/2024, while another resident's Basaglar Kwik Pen was found with an open date of 11/21/2024 and an expiration date of 11/29/2024. Additionally, a second Basaglar Kwik Pen was found without an expiration date. The Director of Nursing stated that insulin should be labeled with the date it is opened and the expiration date, which is typically 28 to 30 days after opening, depending on the manufacturer's instructions. Further inspection of the medication storage room revealed expired supplies, including nine expired g-tube connection tubings and one expired pre-filled saline flush. The Director of Nursing explained that different nurses and the manager on duty are responsible for cleaning the medication storage room and removing expired supplies. The facility's policy requires that medications and biologicals be stored safely and securely, with expired medications removed and destroyed. However, the inspection found that the facility did not adhere to these policies, resulting in expired medications and supplies being present in the storage areas.
Failure to Disinfect Blood Pressure Cuff Between Uses
Penalty
Summary
The facility failed to ensure proper cleaning and disinfection of a reusable blood pressure cuff device between resident uses, affecting three residents out of a sample of eight reviewed for infection control. The deficiency was observed when a Licensed Practical Nurse (LPN) used the device on three residents without cleaning it before or after each use. The LPN acknowledged the requirement to disinfect the device between uses but admitted to not doing so. The Director of Nursing and the Infection Control Preventionist confirmed the necessity of disinfecting the blood pressure device between resident uses to prevent infection spread. The facility's policy, revised in 2014, mandates that non-critical resident-care items, such as blood pressure cuffs, be cleaned and disinfected according to CDC recommendations and OSHA standards. The failure to adhere to these protocols was observed during the survey, leading to the identified deficiency.
Failure to Follow Fall Prevention Plan and Provide Adequate Supervision
Penalty
Summary
The facility failed to follow a resident's plan of care interventions for fall prevention and did not provide the resident with a working call light. The resident, a [AGE] year-old female with multiple diagnoses including Schizophrenia, Chronic respiratory failure, and Type 2 diabetes, was assessed as high risk for falls. Despite being on 1:1 supervision, the resident was found alone in her room attempting to transfer to her wheelchair, which was out of reach. The resident's call light was missing its cord and was not usable, and the exposed sharp metal conduit posed an additional hazard. The resident had to be prompted by the surveyor to remain seated until help arrived, indicating a lack of adequate supervision and failure to ensure the call light was accessible as per the care plan. The resident did not have her soft helmet on, and no 1:1 supervision was present at the time of observation. The LPN on duty was unaware of the resident's need for assistance and the missing call light cord, and the CNA was not present. The DON provided a list of interventions that were supposed to be in place, including reorienting the resident, ensuring proper footwear, placing the resident in common areas for observation, and keeping the call light within reach. However, these interventions were not followed, leading to the resident's near fall. The resident had a history of multiple falls, including two recent significant falls that resulted in injuries. The first fall occurred in the hallway, resulting in a laceration and a nondisplaced fracture of the seventh cervical vertebra. The second fall occurred in the dining room, where the resident slid from her wheelchair and reopened a previous injury, requiring additional sutures. Despite these incidents, the facility failed to ensure the resident's safety by not adhering to the care plan interventions and not providing adequate supervision. The physician and staff acknowledged the resident's non-compliance with reeducation for fall prevention and the serious risk posed by her condition, yet the necessary precautions were not consistently implemented. The facility did not produce a fall prevention/supervision policy when requested, further highlighting the deficiency in their care practices.
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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 Chicago
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Elevate Care Chicago North | 0.1 mi | ★★★★★ | 6 | 0 |
| Buckingham Pavilion | 0.2 mi | ★★★★★ | 6 | 0 |
| Dobson Plaza | 0.7 mi | ★★★★★ | 0 | 0 |
| Warren Park Health & Living Ctr | 0.9 mi | ★★★★★ | 12 | 0 |
| Clark Manor | 0.9 mi | ★★★★★ | 1 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.