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 Richwood Nursing & Rehab during CMS and state inspections, most recent first.
The facility did not complete required annual performance evaluations for all CNAs reviewed, despite each CNA completing annual training. Personnel files lacked documentation of evaluations within the required timeframe, and both the DON and Administrator confirmed responsibility for these reviews but were unaware they had not been completed.
A resident's room was used to store multiple wheelchairs, leg extenders, and a large box, with staff entering to retrieve and return equipment, compromising the resident's privacy and the homelike environment. Facility policy required a personalized, homelike setting and respect for resident privacy, but interviews with the SSD, DON, and Administrator confirmed that equipment should not have been stored in the resident's room.
Two residents did not receive care as outlined in their person-centered care plans: one with severe cognitive impairment and fall risk did not consistently have a nonslip material in her wheelchair as required, and another with weakness and dysphagia was repeatedly observed eating without the one-person assist specified in her care plan. Staff interviews confirmed that interventions were not reliably implemented or monitored.
Two residents did not receive timely and adequate assistance with ADLs. One resident, frequently incontinent and on a diuretic, was left wet for extended periods at night after calling for help. Another resident, assessed to need one-person assist with eating due to cognitive and physical impairments, was repeatedly observed eating alone without staff support, resulting in low intake and difficulty managing food. Staff interviews and facility policy confirmed expectations for regular care, but these were not met.
A resident with significant fall risk factors, including cognitive impairment and immobility, experienced multiple falls despite a care plan intervention requiring dycem in the wheelchair to prevent sliding. The dycem was not consistently present due to the resident discarding it and inconsistent staff monitoring, with audits and staff education lacking proper documentation. Leadership interviews revealed gaps in communication and oversight regarding the intervention.
A resident with COPD, CHF, and pulmonary hypertension who required continuous oxygen therapy was observed with a nasal cannula attached to a portable oxygen tank that was not stored in a bag when not in use, contrary to facility policy and infection control protocols. The Infection Preventionist confirmed that proper storage procedures were not followed, despite staff awareness and available supplies.
A resident with Parkinson's Disease fell from a transport van after a CNA released the wheelchair restraints before ensuring the hydraulic lift was in place. The resident, who was cognitively intact and used a wheelchair, sustained a head injury, rib fractures, and a cervical spine strain. The facility's policy lacked specific steps for using the mechanical lift, and staff interviews revealed inadequate training on its operation.
Failure to Complete Annual CNA Performance Evaluations
Penalty
Summary
The facility failed to complete annual performance evaluations for all Certified Nursing Assistants (CNAs) reviewed, as required by both facility policy and regulatory standards. Personnel files for four CNAs showed that while each had completed the mandated annual online and in-person training, there was no documented evidence of a performance evaluation within the required 12-month period. Facility policies specified that job performance should be reviewed and evaluated at least annually, and that competency requirements and training effectiveness should be monitored by nursing leadership. Despite these policies, the records lacked documentation of completed evaluations for the specified timeframe for each CNA. Interviews with the Director of Nursing (DON) and the Administrator confirmed that department heads, including the DON, are responsible for conducting annual staff performance reviews. Both acknowledged the importance of these evaluations for assessing staff roles, identifying training needs, and determining eligibility for pay raises. The DON indicated a recent transition from handwritten to electronic evaluations and was unaware that CNA evaluations had not been completed. The Administrator also recognized the potential for missed training needs if reviews were not conducted in a timely manner.
Failure to Maintain Homelike Environment Due to Equipment Storage in Resident Room
Penalty
Summary
The facility failed to provide a safe, clean, comfortable, and homelike environment for one resident. Over the course of three days, surveyors observed multiple wheelchairs, wheelchair leg extenders, and a large box being stored on the opposite side of the resident's room. These items were not personal belongings of the resident but were instead used by staff and returned to the room after use. The resident confirmed that the facility used her room for storage, with staff frequently entering to retrieve or return equipment. Facility policy required that staff maximize a homelike setting and respect residents' rights to privacy and personal possessions. Interviews with the Social Services Director, DON, and Administrator confirmed that equipment should not be stored in resident rooms, as it compromised the resident's privacy, dignity, and the homelike environment. The resident's medical record indicated she had abnormal posture, muscle weakness, and epilepsy, and at the time of the observations, she was either lying in bed or receiving a breathing treatment in her wheelchair.
Failure to Implement Person-Centered Care Plans for Fall Prevention and Eating Assistance
Penalty
Summary
The facility failed to implement comprehensive, person-centered care plans for two residents, resulting in deficiencies related to fall prevention and assistance with eating. For one resident with immobility syndrome, congestive heart failure, and severe cognitive impairment, the care plan included the use of dycem (a nonslip material) in the wheelchair to prevent falls. Despite multiple falls and documented interventions, the dycem was not consistently present in the wheelchair, as the resident was found to have removed it without staff noticing. Staff education on the intervention was inconsistently documented, and visual audits by the Infection Preventionist did not identify the missing dycem. Another resident, admitted with metabolic encephalopathy, muscle weakness, dysphagia, and cognitive communication deficits, was assessed as requiring moderate assistance with self-feeding. The care plan specified one-person assistance for eating, but repeated observations showed the resident eating alone in her room without staff present. The resident exhibited difficulty handling food and drink, resulting in spills and incomplete meal consumption, yet no staff were observed providing the required assistance during multiple meals. Interviews with facility staff, including the DON, Infection Preventionist, and MDS Nurse, confirmed that care plan interventions were not consistently implemented or monitored. Staff acknowledged the importance of following individualized care plans but failed to ensure interventions were in place as documented. The facility did not provide a specific policy for care plans, and there was a lack of consistent documentation and follow-through regarding staff education and intervention audits.
Failure to Provide Timely ADL Assistance for Incontinent and Dependent Residents
Penalty
Summary
The facility failed to provide sufficient and timely assistance with activities of daily living (ADLs) for two residents who were unable to perform these tasks independently. One resident, who was frequently incontinent of both bladder and bowel and prescribed a diuretic, reported multiple instances where he called for incontinence care at night and was left wet for up to two hours before receiving assistance. This resident was cognitively intact and able to track the time using a clock and watch. Interviews with staff, including CNAs and LPNs, confirmed that the facility's expectation was to check and change residents every two hours, or more frequently for those on diuretics, and that delays in care were not acceptable unless there was an emergency. Staff also acknowledged that agency staff were used frequently, and some agency staff did not always complete necessary care, leading to residents being left wet at shift changes. Another resident was assessed and care planned to require one-person assistance with eating due to impaired cognition, muscle weakness, and a severe cognitive communication impairment. Despite this, observations over several days showed the resident eating alone in her room without staff assistance, struggling with tremors, and spilling food and drink. Documentation indicated that the resident's intake was low, and therapy assessments supported the need for moderate assistance with self-feeding. The care plan, based on therapy evaluations, was not followed, and staff interviews confirmed that care plans should not be altered by CNAs without discussion with nursing managers or the MDS nurse. Facility policies reviewed indicated that residents unable to perform ADLs independently were to be provided with appropriate care and services, including support with elimination and eating, in accordance with their care plans. Despite these policies and staff awareness of expectations, the facility did not ensure timely and adequate assistance for these two residents, resulting in unmet care needs related to incontinence and eating support.
Failure to Consistently Implement Fall Prevention Intervention for At-Risk Resident
Penalty
Summary
The facility failed to ensure that a resident was free from accident hazards and that adequate supervision and interventions were consistently provided to prevent falls. The resident, who had diagnoses including congestive heart failure, immobility syndrome, and weakness, was identified as being at risk for falls. The care plan included the use of dycem, a non-slip material, in the resident’s wheelchair to prevent sliding and potential falls. Despite this intervention being documented in the care plan and staff being educated on its use, the resident experienced two non-injury falls within a short period. Review of records and staff interviews revealed that the dycem was not consistently present in the resident’s wheelchair as intended. The resident was able to self-propel in the wheelchair but was not able to stand independently and had a history of attempting to transfer herself, leading to falls. Staff and quality assurance personnel reported that the resident had thrown the dycem away at times, and while visual audits were conducted to check for the presence of the dycem, these audits were not documented. Additionally, staff education on the intervention was not consistently tracked, and training logs for some sessions could not be located. Interviews with facility leadership indicated a lack of clear communication and follow-through regarding the intervention. The DON and IP/QA acknowledged the importance of the dycem in preventing falls but could not provide consistent documentation of staff education or audits. The administrator was not familiar with the intervention and deferred responsibility to the nursing department, indicating a gap in oversight and understanding of the specific fall prevention measures required for the resident.
Failure to Properly Store Oxygen Equipment
Penalty
Summary
The facility failed to provide respiratory care consistent with professional standards of practice for a resident requiring oxygen therapy. Observations on two separate days showed that the resident's nasal cannula, which was attached to a portable oxygen tank on the resident's wheelchair, was not stored in a bag when not in use. Instead, the cannula was seen hanging off the wheelchair or wrapped around the wheelchair handle, contrary to the facility's policy and infection control protocols. The facility's policy required all supplies and equipment to be stored according to the manufacturer's recommendations, and the care plan for the resident included following infection control protocols for oxygen therapy. The resident involved had a history of chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), and pulmonary hypertension, and was admitted with an order for continuous oxygen therapy to maintain oxygen saturation above 90%. The Infection Preventionist confirmed that nasal cannulas should be stored in a bag when not in use to prevent contamination and that bags were provided in all rooms for this purpose. The failure to properly store the nasal cannula was observed despite these established protocols and staff knowledge.
Resident Falls from Transport Van Due to Inadequate Safety Measures
Penalty
Summary
The facility failed to prevent an accident involving a resident, identified as R19, who fell from the back of a transport van. The incident occurred when a Certified Nursing Assistant (CNA1) released the safety restraints on R19's wheelchair before ensuring that the hydraulic lift was in place. As a result, R19 propelled herself backwards, flipped over her wheelchair, and fell over 10 feet onto the pavement, sustaining a closed head injury, rib fractures, and a cervical spine strain. R19 was a resident with Parkinson's Disease, muscle weakness, lack of coordination, and abnormalities of gait and mobility. She was cognitively intact and used a wheelchair for mobility, requiring partial to moderate assistance with transfers. On the day of the incident, R19 was being transported to a hospital appointment. Despite CNA1's instructions to wait, R19 began to propel herself backwards, leading to the fall. The facility's policy on vehicle safety did not include specific steps for using the mechanical lift, contributing to the incident. Interviews with staff revealed that CNA1 was aware of R19's impulsive behaviors but failed to ensure the lift was in place before releasing the wheelchair's restraints. Another CNA, CNA2, who was present during the incident, did not recall receiving formal training on operating the hydraulic lift. The Director of Nursing (DON) and the Administrator were informed of the incident, and it was noted that the facility's policies did not adequately address the procedures for safely using the van's mechanical lift.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 322 citations issued within 25 miles in the last 12 months — including the 9 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near La Grange
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| The Springs At Oldham Reserve | 1.3 mi | ★★★★★ | 4 | 0 |
| Forest Springs Health Campus | 10 mi | ★★★★★ | 3 | 0 |
| New Castle Nursing & Rehab | 11 mi | ★★★★★ | 0 | 0 |
| Valhalla Post Acute | 12.5 mi | ★★★★★ | 13 | 0 |
| The Willows At Springhurst | 13.2 mi | ★★★★★ | 4 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
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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.