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Health Inspection

Nexus Pavilion At Belleville

March 14, 2025 · Belleville, IL · 727 North 17th Street
Citations 1
CMS Rating 1/5
Beds 180
Provider ID 145290
Healthcare Facility
Nexus Pavilion At Belleville
Belleville, IL  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)  ·  12 pages
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

Nexus Pavilion at Belleville in BELLEVILLE, IL — inspection on March 14, 2025.

Found 1 citation. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

Inspection Findings

FF401
Minimal harm or in his room and moved (R402) off the hall. I go back in the bathroom to wash hands only to see (R401) Few On 5/16/2025 at 2:03 PM, V10, Certified Nursing Assistant (CNA) stated, I had never seen (R401) and affected

Investigation initiated.

Final to follow.

R401's Final Incident Report with incident date of 5/9/2025 at 7:00 AM, document, Upon investigation, the facility is unable to substantiate the res (resident) to resident complaint.

The residents both were unable to communicate any information to interviewer.

Staff were inconsistent with statements due to them not being able to fully see what had taken place down the hall.

All staff were in-serviced on abuse and neglect, process of reporting and protective oversight. No injuries noted on either resident. (R401) was sent out due to some change in conditions with communicating with staff.

Statement dated 5/9/2025 documents, At about 6:30 I was bringing my resident from the dining room, and I saw (R401) punching on (R402) across the head. Me and 2 other staff went down there to stop him, he walked away as if he didn't do anything.

Signature of author was not readable.

R401's Abuse Investigation folder only had three statements from staff.

The above statement dated 5/9/2025 documents there were a total of three staff members but does not document their names and there were no additional statements to review.

145290

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 145290 B.

Wing 03/14/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Belleville Healthcare Center 727 North 17th Street Belleville, IL 62226

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in BELLEVILLE, IL, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Nexus Pavilion at Belleville or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


More Reports

About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.