Goldwater Care Clinton: Toileting Delays Leave Residents Soiled - IL
Federal inspectors visited Goldwater Care Clinton on April 29, 2026, following a complaint. They interviewed three residents about nighttime toileting assistance. All three were cognitively intact, according to their own assessments. All three described the same pattern: call lights silenced by staff who then disappeared.
The first resident, who has MS, chronic respiratory failure, morbid obesity, and overactive bladder, requires staff help both to transfer to the toilet and to clean herself afterward. She told inspectors that the call light shutoff happened regularly at night, that she had waited up to thirty minutes for someone to return, and that the accidents made her feel "not good." A nursing aide interviewed the following morning said the resident "makes reliable statements and is pretty accurate with what she has to say to people."
The second resident, who has muscle wasting, generalized anxiety disorder, and depression, also needs partial assistance to reach the toilet and has both bowel and bladder incontinence. She told inspectors that staff sometimes take thirty minutes at night to answer her call light for toileting help. She said it happens daily.
The third resident has an overactive bladder and an active urinary tract infection. Her care plan requires substantial assistance just to transfer to the toilet, meaning she cannot manage the move at all without significant staff support. She told inspectors that a couple of nights before the inspection, she activated her call light at 3:00 in the morning and staff did not arrive for two hours. She said it happens often at night, and that it is worse when agency staff are working. She also described the same call light shutoff: someone comes in, silences the light, and leaves. A licensed practical nurse interviewed that afternoon said both this resident and the second resident make reliable statements, have no behavioral issues, and do not make false allegations.
The facility's own call light policy, dated November 2012, states that staff will answer resident call lights in a timely manner.
What the policy says and what these three residents experienced are not the same thing.
Nursing homes that use agency, or contract, staff to fill overnight shifts have documented this problem repeatedly across the country. The third resident named agency staff specifically. Whether Goldwater Care Clinton was relying heavily on agency workers during overnight hours, and whether that contributed to the pattern all three residents described, is not addressed in the inspection report.
What is addressed is the specific, repeated experience of people who cannot get to the bathroom without help, who asked for that help, and who were left waiting, or were made to believe help was coming when it was not. Silencing a call light without responding to the resident is not a miscommunication or a staffing delay. It is a choice someone made, more than once, on more than one night, with more than one resident.
The woman with MS has overactive bladder as a diagnosis. Her body does not give her much time. She pressed the light, heard the click, and waited anyway, because what else was she going to do. She had accidents. She told an inspector it made her feel not good, which is a careful way of describing something that is not a small thing, being a grown adult who cannot control when she soils herself because the person assigned to help her turned off the light and walked away.
The inspection was classified as causing minimal harm or potential for actual harm. The residents who spoke to inspectors might describe it differently.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Goldwater Care Clinton from 2026-04-29 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 7, 2026 · Our methodology
GOLDWATER CARE CLINTON in CLINTON, IL was cited for violations during a health inspection on April 29, 2026.
Federal inspectors visited Goldwater Care Clinton on April 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.