Heartland Nursing & Rehab

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

observation, interview and record review the facility failed to properly transfer a resident (Resident R3), for one of three residents (Resident R3) reviewed for falls in a sample list of ten. Findings include:On 10/20/25 at 10:10 AM Resident R3 was sitting on a full mechanical lift sling in her wheelchair. Resident R3 stated Resident R3 fell during a staff assisted transfer

in July 2025 that resulted in right leg fracture. Resident R3 stated since then Resident R3 has received therapy, Resident R3 can't use her legs to walk so she transfers with a full mechanical lift. Resident R3 stated yesterday the full mechanical lift wasn't working so the Certified Nursing Assistant (CNA), V7, used the sit to stand mechanical lift to transfer Resident R3 from the wheelchair into bed. Resident R3 stated during the transfer, Resident R3 said Dear Jesus please don't let me fall. Resident R3's Minimum Data Set (MDS) dated [DATE REDACTED] documents Resident R3 as cognitively intact and is dependent on staff for transfers. Resident R3's active diagnosis list includes nondisplaced comminuted fracture of shaft of right femur, subsequent encounter for closed fracture with routine healing as of 7/23/25.Resident R3's active Care Plan includes

an intervention dated 10/16/25 TRANSFER: The resident (Resident R3) requires Mechanical Aid Sling, (full mechanical lift) for transfers. PT/OT (physical/occupational therapy) is working with resident (Resident R3) and this may change with their recommendation.On 10/20/25 at 10:56 AM V7 CNA confirmed V7 worked on Resident R3's hall on 10/19/25. V7 stated sometimes one of the full mechanical lifts doesn't work and yesterday the lift on Resident R3's hallway wouldn't go up. V7 stated V7 put in a work order request, but maintenance staff aren't in the facility on Sundays. V7 confirmed V7 used a sit to stand lift to transfer Resident R3 on 10/19/25. V7 confirmed Resident R3 transfers with full mechanical lift. V7 stated therapy staff have been working with Resident R3 on two assist transfers to the commode.On 10/20/25 at 11:34 AM V13 Physical Therapy Assistant/Director of Rehab stated Resident R3 continues on PT/OT and transfers with contact guard and minimal assist for stand pivot transfers in therapy.

V13 stated floor staff should use a full mechanical lift for Resident R3's transfers and Resident R3 has not been approved to use the sit to stand lift.On 10/10/25 at 12:10 PM V8 MDS/Care Plan Coordinator confirmed Resident R3's current transfer status is full mechanical lift and may adjust per therapy recommendation. V8 stated V8 needs to check with therapy on Resident R3's transfer status since therapy staff have been working with Resident R3 to stand and use

the commode. V8 stated V8 has not received any recommendations from therapy to change Resident R3's transfer status. The facility's Safe Lifting, Transferring and Movement of Residents policy dated July 2017 documents nursing staff and rehabilitation staff shall in conjunction assess each resident's needs for transfers assistance on an ongoing basis, and resident transfer needs will be documented in the care plan.

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date

these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE

TITLE

(X6) DATE

FORM CMS-2567 (02/99) Previous Versions Obsolete

Facility ID:

If continuation sheet

Event ID:

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/20/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Heartland Nursing & Rehab

410 Northwest Third Casey, IL 62420

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

Federal health inspectors cited HEARTLAND NURSING & REHAB in CASEY, IL for a deficiency under regulatory tag F-F0908 during a complaint investigation conducted on 2025-10-20.

Category: Environmental Deficiencies

The facility was found deficient in the following area: Keep all essential equipment working safely.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 2 deficiencies cited during this inspection of HEARTLAND NURSING & REHAB.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-11-07.