Centralia Manor
CENTRALIA MANOR in CENTRALIA, IL — inspection on September 9, 2025.
Found 7 citations. 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
incident.On [DATE] at 3:47 PM, V1 (Administrator) stated right before she arrived at the facility on
jeopardy to resident health or services had been called for R1 and explained what happened to V1. V1 stated once she arrived at the safety facility she began talking to staff. V1 stated her investigation found V11 checked R1's blood sugar around 5:55 AM and R1 wanted to stay up in his wheelchair. V1 stated she spoke with CNA's, and they
stated they notified V11, and once code status was confirmed they got the crash cart and V3 and V10 started CPR.
After reviewing the staff interviews with V1 this surveyor asked her what the outcome of her investigation was, V1 stated it should not have taken 15 minutes to initiate CPR. V1 stated she reached out to V11, and she wasn't very forthcoming. V1 stated V11 was supposed to come to the facility and talk and she didn't show up and couldn't be reached by phone. V1 stated V11 effectively terminated herself by not showing up.On [DATE] at 2:00 PM, V7 (Physician) stated he saw R1 the day before he passed away.
When asked if he considered R1 to be end of life, V7 stated on [DATE] R1 seemed to be stable but had a lot of comorbidities including cardiac problems and Covid.
When asked if the facility staff would have initiated CPR earlier if it would have changed the outcome, V7 stated, I doubt it. He (R1) had significant comorbid condition.
You can never know for sure.
When asked what his expectations as the physician would be if they found a resident with no pulse and no respirations who was a full code, V7 stated, Do CPR and send them to the hospital as soon as possible.The facility Policy 3.06 on Emergencies documents, It is the policy of the facility to provide emergency care to a resident in need of it.
Emergency Care Procedure: 1.
Nurse in charge of resident will evaluate resident's condition. If help is needed and there is more than one nurse available, the nurse assigned to resident will stay with resident and send another staff member to get another nurse.
The staff member will also bring emergency equipment if needed. A nurse will notify resident's physician and follow orders received.
Call ambulance, notify family, and complete transfer form.
Call emergency room and let them know resident is on the way.Documentation of treatment and resident's response during emergency must be done in clinical record.I.
Cardiac Arrest: When the facility has only one (1) employee on duty, that employee shall have been certified within the past twelve (12) months in the provision of basic life support by an American Heart Association or American Red Cross certified training program.
When there is more than one (1) person on duty in the facility, at least one (1) person on duty shall be so certified.
Any facility employee who is on duty may be utilized to assist in these medical emergencies.
Signs and Symptoms: 1.
Immediate loss of consciousness. 2.
Absence of palpable carotidal or femoral pulse. 3.
Absence of audible heart sounds. 4.
Absence of breath sounds or air movement throughout the nose or mouth. 5.
Convulsions (may or may not be present). 6.
Dilation of pupils of eyes. 7.
Ashen gray color.
Treatment: 8.
Note the time as soon as the cardiac arrest is determined.
Summon help immediately. 9.
Provide CPR if determine appropriate according to the POLST/DNR form. CPR should be performed in accordance with the guidelines set by American Heart Association or the American Red Cross. 10.
Utilize AED (Automated External Defibrillator) according to instructions on machine for use.The Immediate Jeopardy that began on [DATE] was removed [DATE].
The deficient practice was corrected on [DATE] after the facility took the following action to correct the noncompliance: Facility administrator (V1) and DON (V2) were in-serviced by the regional nurse (V13) on [DATE] on the emergencies policy 3.06, specifically regarding cardiac arrest and CPR.DON (V2) initiated and completed in-servicing with all nursing staff on [DATE], on the emergencies policy 3.06 specifically regarding cardiac arrest and CPR.DON (V2) initiated and completed in-servicing with all nursing staff on [DATE] on location of code status/POLST for residents.V11 (RN) did not return to work after [DATE].Plan was added to the facility QA (Quality Assurance) program regarding CPR and code status on [DATE].The facility DON or designee will audit 10 employees per week for a month to ensure that location of code status/POLST is known and understanding of the emergencies policy.This will remain as part of the facility QA process for continued monitoring.Completion Date: [DATE].
145666 09/09/2025
Centralia Manor 1910 East McCord Rte 161 East Centralia, IL 62801
Review of the facility training/in-service records do not document specific annual training for all staff. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate documentation annual training had been completed for all staff.The facility Policy 1.10 on Inservice Training revised on 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel. 2. To provide continuing education opportunities and promote job satisfaction
145666 09/09/2025
Centralia Manor 1910 East McCord Rte 161 East Centralia, IL 62801
Review of the facility training/in-service records do not document effective communication training for staff. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate documentation effective communication training had been completed for all staff.
The facility Policy 1.10 on Inservice Training revised 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel. 2. To provide continuing education opportunities and promote job satisfaction
145666 09/09/2025
Centralia Manor 1910 East McCord Rte 161 East Centralia, IL 62801
Review of the facility training/in-service records do not document staff were trained on resident rights. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate documentation staff had been trained on resident rights.
The facility Policy 1.10 on Inservice Training revised 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel. 2. To provide continuing education opportunities and promote job satisfaction
145666 09/09/2025
Centralia Manor 1910 East McCord Rte 161 East Centralia, IL 62801
residing at the facility.
Findings Include:The facility Resident Directory dated 9/3/2025 documents
records do not document specific compliance and ethics training for all staff. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate documentation compliance and ethics training had been completed for all staff.
The facility Policy 1.10 on Inservice Training revised 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel. 2. To provide continuing education opportunities and promote job satisfaction
145666 09/09/2025
Centralia Manor 1910 East McCord Rte 161 East Centralia, IL 62801
Review of the facility training/in-service records do not document specific the required annual in-service training for CNA's was completed. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate documentation the required CNA training had been completed.
The facility Policy 1.10 on Inservice Training revised 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel. 2.
To provide continuing education opportunities and promote job satisfaction
145666 09/09/2025
Centralia Manor 1910 East McCord Rte 161 East Centralia, IL 62801
Review of the facility training/in-service records do not document behavioral health services training for all staff. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate staff were trained on behavioral health services.
The facility Policy 1.10 on Inservice Training revised 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel. 2. To provide continuing education opportunities and promote job satisfaction
Frequently Asked Questions
More Reports
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.