Benton Rehabilitation And Health Care Center
Inspection Findings
F-Tag F0658
F 0658 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
provided this surveyor Resident R16's Pulmonary Function Test results dated 3/20/25. Resident R16's undated Care Profile does not document a physician order for PFT testing to be performed on or around 3/20/25. On 9/29/25 at 2:39 PM, Resident R16 stated she doesn't remember if she had PFT tests done. On 9/29/25 at 10:43 AM, V6 (MDS Coordinator) stated Pulmonary Function Tests (PFT's) have been done on residents without physician orders in the past. V6 stated the respiratory therapist showed up this week to do more and they didn't have
the orders, so they didn't do them. On 9/29/25 at 11:26 AM, V12 (Registered Nurse) stated they have an outside company who sends a respiratory therapist to the facility to perform PFT testing on the residents.
V12 stated they had done testing twice as far as she knew, and they were testing everyone in the facility.
When asked why they were doing the test on all of the residents, V12 stated she didn't know. V12 stated
they didn't have a physician order for them and when they came in the last time, V21 (Physician) wouldn't sign the orders to do them. On 9/29/25 at 2:50 PM, V20 (Licensed Practical Nurse) stated she didn't think V21 (Physician) felt the PFT tests were necessary and didn't want all of the residents to have them. V20 stated V1 asked the nurses to get V21 to sign the orders and he refused.On 9/29/25 at 12:29 PM, V1 (Administrator) stated the oxygen supply company sends the respiratory therapist to the facility to do the PFT's. V1 stated V21 (Respiratory Therapist) came to the facility last week and wouldn't do the tests because the physician had not given the orders. V1 stated they are doing the tests to see if residents have chronic obstructive pulmonary disease (COPD) to make sure they are treating everything they need to. V1 stated according to her regional with corporate it is the gold standard of care and anyone who doesn't have
a diagnosis of COPD should be screened upon admission. On 9/29/25 at 4:04 PM, V22 (Registered Respiratory Therapist) stated she went to the facility in 3/2025 and performed PFT tests on residents. When asked if there were physician orders in place prior to performing those tests, V22 stated the facility told her there were but she didn't see the actual orders. On 9/29/25 at 4:18 PM, V5 (Director of Nurses) stated there should be physician orders in place prior to performing PFT tests on residents and she wasn't sure why there weren't orders documented in the medical records for the tests performed on 3/20/25. On 9/30/25 at 11:21 AM, V1 (Administrator) stated the facility was owned/operated by a different company in 3/2025 and there was no policy available for physician orders for that time frame.On 9/30/25 at 3:00 PM, V21 (Physician) stated he didn't remember if he gave orders for the PFT to be administered in 3/2025.
Event ID:
Facility ID:
If continuation sheet
Benton Rehabilitation and Health Care Center in BENTON, IL inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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 BENTON, 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 Benton Rehabilitation and Health Care Center or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.