Resthave Home: Antibiotic Overuse Violations Found - IL
Federal inspectors visited the Morrison, Illinois nursing home on January 29, 2026, following a complaint. What they found was a pattern: four residents receiving antibiotics for urinary tract infection prevention, none of them tested to confirm an active infection, none of their orders carrying a stop date, and a nursing director who, in her own words, had never gone back to reassess any of them after the prescriptions were written.
The director of nursing, identified in the inspection report as V2, also held the title of infection preventionist. She told inspectors on January 28 that she was responsible for monitoring antibiotic use across the facility and reviewed residents' antibiotic orders once a month. She also acknowledged that all antibiotic orders should include a stop date and an associated diagnosis. Her own facility's written antibiotic stewardship policy, dated December 2022, said the same thing.
None of the four residents' orders met those requirements.
One resident, identified as R6, was started on Macrobid on January 2, 2026, not because she had an active UTI, but because she had a history of frequent UTIs. No urinalysis was collected before the prescription was written. V2 told inspectors she had not reassessed R6 for continued need since the medication began nearly four weeks earlier. The order had no stop date.
R13, a resident receiving hospice care, had been on Cephalexin since December 30, 2025. His hospice service prescribed it because of his history of UTIs, not because he had one at the time. The facility had never collected a urine sample from R13 to test or culture before the antibiotic was started. V2 told inspectors she had never spoken with R13's hospice team about whether he still needed the medication. His order listed no diagnosis and no stop date.
R14 had been on Bactrim since November 11, 2025, taking it twice a week because, V2 explained, R14 had apparently had bad UTIs in the past and wanted to stay on it. V2 said R14 had never been diagnosed with an acute UTI during her time at the facility. The facility had never collected a urinalysis from R14 while she was a resident. V2 told inspectors she had never discussed R14's continued use of Bactrim with the facility's nurse practitioner. The order had no stop date.
The fourth resident, R15, was admitted from a local hospital in December 2025 and discharged on January 9, 2026. He arrived with a physician order for Nitrofurantoin for UTI prevention. The facility continued it without question. "We just carried the order over from the hospital for his Nitrofurantoin because he had a history of UTIs," V2 told inspectors. "We never checked a urinalysis on him prior to continuing the medication. I never spoke with the NP about the need to continue this medication."
He received the antibiotic from December 21 until his discharge on January 9.
The problem with prescribing antibiotics without confirming an infection is not bureaucratic. Antibiotic resistance develops when bacteria are repeatedly exposed to drugs they learn to survive. A patient who takes antibiotics for months without a confirmed infection is not being protected from harm. The bacteria that colonize that patient are being trained. If a real infection develops later, the drugs may not work.
Prophylactic antibiotic use in nursing homes is not categorically prohibited, but it requires monitoring, documented rationale, and regular reassessment. V2 described a monthly review process with the facility's nurse practitioner. What the inspection found was that the process existed on paper and, in at least these four cases, produced nothing. No urinalysis. No documented reassessment. No stop dates. No conversations with the prescribers.
V2 told inspectors she shared the infection preventionist role with the facility administrator, V1, but noted that V1 was not a nurse. The antibiotic surveillance responsibility, she said, was hers.
The facility's own December 2022 antibiotic stewardship policy required that every antibiotic order include a drug name, dose, frequency, start date, stop date, route of administration, and indication for use. Inspectors reviewed five residents for unnecessary medications. Four of them had orders that violated the policy the facility had written for itself.
Resthave Home is a county-owned nursing home at 408 Maple Avenue in Morrison, a small city in Whiteside County in northwestern Illinois. The inspection was classified as a complaint survey. The level of harm was assessed as minimal harm or potential for actual harm, the lower end of the federal deficiency scale. The finding affected some residents, not an isolated one.
V2's candor with inspectors was notable. She did not dispute the findings. She confirmed them, one resident at a time, explaining each gap in her own words. She knew R6 hadn't been tested. She knew she hadn't called R13's hospice team. She knew R14 had never had a confirmed infection at the facility. She knew R15's order had been carried over without review.
What she had not done, by her own account, was act on any of it.
R14 had been on Bactrim since November. R13 had been on Cephalexin since late December. R6 had been on Macrobid since the first week of January. All three were still residents when inspectors arrived. None of their orders had end dates. None of their continued use had been formally reviewed with the prescribing nurse practitioner.
The drugs kept coming. Nobody had stopped them.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Resthave Home-whiteside County from 2026-01-29 including all violations, facility responses, and corrective action plans.
Download the official CMS inspection PDF from Medicare.gov
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: September 19, 2026 · Our methodology
RESTHAVE HOME-WHITESIDE COUNTY in MORRISON, IL was cited for violations during a health inspection on January 29, 2026.
Federal inspectors visited the Morrison, Illinois nursing home on January 29, 2026, following a complaint.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.