Above average — CMS composite of the measures below.
A standard survey is most likely before around November 2026
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 Care And Rehab - Boscobel during CMS and state inspections, most recent first.
A resident with a history of stroke and other health conditions experienced significant weight loss and was hospitalized due to the facility's failure to ensure adequate hydration and nutrition. The resident's fluid intake was not documented, and the care plan was not updated to prevent dehydration. Despite the resident's refusal to eat, the facility did not provide adequate alternatives or document intake, leading to severe health issues and a finding of Immediate Jeopardy.
The facility failed to ensure proper documentation and communication of advance directives for several residents. POST forms were not signed by residents or their representatives, and discrepancies were found in code status documentation. Interviews revealed a lack of proper discussions and documentation regarding advance directives, leading to potential confusion in emergencies.
A facility failed to verify the placement of a feeding tube before administering medications to a resident, as observed by a surveyor. The RN did not check the tube's placement, contrary to the facility's policy, which requires verification before any feeding, flushing, or medication administration. Interviews with staff revealed inconsistencies in the practice of verifying tube placement, leading to a deficiency in care.
Failure to Ensure Adequate Hydration and Nutrition
Penalty
Summary
The facility failed to ensure adequate hydration and nutrition for a resident, leading to significant health issues. The resident, who had a history of stroke, dysphagia, hypertension, COPD, and type 2 diabetes, was admitted to the facility and began losing weight immediately. Despite being cognitively intact and his own decision-maker, the resident's fluid intake was not documented or evaluated to meet daily needs, and his care plan was not updated with individualized approaches to prevent dehydration after lab results indicated reduced kidney function. The resident experienced a rapid weight loss of 37.3 pounds within a month, nearly 20% of his body weight, and was hospitalized with severe health conditions, including dehydration, acute kidney injury, hypernatremia, metabolic encephalopathy, and severe sepsis. The facility did not have a systematic process to monitor and assess the resident's daily fluid intake or needs, nor did it implement corrective actions to prevent dehydration. The resident's refusal to eat was not adequately addressed, as the facility did not provide education on the risks and benefits of refusing food and drink, nor did it offer foods the resident liked, such as ice cream, in a timely manner. The facility's policies on weight monitoring and hydration were not effectively implemented. The resident's weight loss and fluid intake were not consistently recorded or assessed, and the care plan was not updated with individualized interventions to encourage fluid intake. Despite the resident's right to refuse meals, the facility failed to provide adequate alternatives or document the resident's intake of supplements and snacks. This lack of documentation and failure to address the resident's nutritional needs resulted in a finding of Immediate Jeopardy.
Failure to Ensure Proper Documentation of Advance Directives
Penalty
Summary
The facility failed to ensure that all residents were able to formulate an advance directive, specifically related to code status, for 9 of 12 residents reviewed. The Provider Orders for Scope of Treatment (POST) forms for several residents were not signed by the residents or their representatives, indicating a lack of proper documentation and communication regarding their code status preferences. For instance, residents R7, R185, R8, R22, R13, R11, R28, R10, and R17 had POST forms signed by physicians but not by the residents or their representatives, which is a critical oversight in honoring residents' rights to make informed decisions about their care. The facility's policy requires that upon admission, the facility should determine if a resident has executed an advance directive and provide information about the right to refuse treatment and formulate an advance directive. However, interviews with staff and residents revealed that these discussions were either not documented or not conducted as required. For example, R185 did not recall being spoken to about advance directives at the facility, and there was no documentation to show that such a conversation took place. Similarly, R8's Power of Attorney for Healthcare lacked the necessary witness signatures, rendering it invalid. Additionally, discrepancies were found in the documentation of code statuses across different records and locations within the facility. For instance, R22's POST form indicated a Full Code status, while the CNA Kardex in his room showed a DNR status, which could lead to confusion in an emergency. Staff interviews revealed inconsistencies in where and how code statuses were recorded and communicated, further highlighting the facility's failure to ensure accurate and consistent documentation of residents' code status preferences.
Failure to Verify Feeding Tube Placement
Penalty
Summary
The facility failed to ensure proper verification of feeding tube placement for a resident receiving enteral nutrition and medication. During an observation, a Registered Nurse (RN) administered medications to a resident with a jejunostomy tube without verifying the tube's placement, as required by the facility's policy. The policy mandates checking the tube's placement by noting the marking on the tube before administering any feeding, flushing, or medication. However, the RN admitted to not performing this verification step. Further interviews with facility staff, including a Licensed Practical Nurse (LPN) and the Director of Nursing (DON), revealed inconsistencies in the practice of verifying tube placement. The LPN indicated that the tube measurement is recorded on the feeding pump, while the DON confirmed that staff are expected to measure the tube before any administration. This inconsistency in practice and failure to adhere to the facility's policy resulted in a deficiency in the care provided to the resident.
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What surveyors actually found near you
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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 Boscobel
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Dove Healthcare - Fennimore | 10.7 mi | ★★★★★ | 33 | 0 |
| Rivers Edge Nursing And Rehab | 14 mi | ★★★★★ | 34 | 1 |
| Soldiers Grove Health Services | 18 mi | ★★★★★ | 0 | 0 |
| Lancaster Health Services | 20.4 mi | ★★★★★ | 15 | 1 |
| Schmitt Woodland Hills | 20.8 mi | ★★★★★ | 10 | 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.